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Pablo R. Ros
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Radiologi‹al English
šŻ1 Springer
Hospital Reina Sofía
Servicio de Radiología
Avda. Menéndez Pidal s/n.
Córdoba 14004, Spain
Professor of Radiology, Harvard Medical School
Executive Vice Chairman and Associate Radiologist-in-Chief,
Brigham and Women’s Hospital
Chief, Division of Radiology, Dana-Farber Cancer Institute
Harvard Medical School
75 Francis St.
Boston, MA 02115, USA
3-540-29328-0 Springer Berlin Heidelberg New York
978-3-540-29328-6 Springer Berlin Heidelberg New York
Library of Congress Control Number: 2006929202
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O Springer-Verlag Berlin Heidelberg 2007
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To Rosario Alarcon, I do admire you as my
wife, as the mother of my two daughters and
as a successful professional.
R. Ribes
To Silvia, my wife.
P.R. Ros
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The second portion of the book refers to radiology reporting with units
dealing with describing lesions and composing reports, both normal and
abnormal. The third portion of the book deals with “dialects” in radiological English. English speakers are fascinated with different forms of speaking English in different parts of the world such as the United States, Ireland or New Zealand. The same happens in radiology where there are
some specific “dialects” of radiological English in: (1) interventional radiology, (2) on call where a lot of slang terms are used and, finally, (3) in radiological management where administrators use a number of key terms
that permeate the specialty. We close the book with three units on conversational radiological English, communication skills in medicine and a survival conversation guide.
We really hope this book will be helpful to professionals working within
the realm of radiology who are non-native English speakers. This would include not only radiologists, either trained or in training, but also technologists, nurses, administrators, basic scientists, and others who work in diagnostic imaging and its subspecialties. We had fun putting together this
book, thinking about areas to cover and enlisting collaborators who like us
were interested in the subtleties of communication in radiology at many
levels. But now, the final test rests in you the reader. We are sure that you
will find situations that will appear familiar to you, and the book will be
helpful in improving your communication skills in this specialty based so
much on communication with patients, referring physicians and other radiological professionals. Please let us know how to improve this book and
send us your experiences so we can start working on a second edition of
Radiological English.
In short, this manual is intended to make the adaptation to an Englishspeaking radiological environment easier for you than it was for us since
there is no time to be wasted when you are faced with such a great opportunity of personal and radiological development. We hope you enjoy reading this manual as much as we have enjoyed writing it.
Ramón Ribes, MD, PhD
Pablo R. Ros, MD, MPH, FACR
We would like to thank Hansel Otero, MD, for his valuable help in the
preparation of Unit XVI.
We would like to thank Mildred Dewire for her assistance in preparing
the manuscript.
Unit I
Methodological Approach to Radiological English
Introduction ............................................
Unit II
Radiological Grammar
Tenses ................................................
Modal Verbs................................................................................................... 21
Conditionals ................................................................................................... 26
Passive Voice ................................................................................................. 30
Reported Speech ............................................................................................ 33
Questions ....................................................................................................... 36
Infinitive/-Ing ................
Countable and Uncountable Nouns
Articles: A/An and The ................................................................................. 43
Word Order. ................................................... 45
Relative Clauses ............................................................................................. 46
Adjectives . .
Unit III
Scientific Literature: Writing an Article
Preliminary Work
Article Header . .
Main Text....................................................................................................... 65
References...................................................................................................... 72
Additional Material ....................................................................................... 79
Final Tips ....................................................................................................... 80
Unit IV
Letters to Editors of Radiological Journals
Submission Letters ........................................................................................ 84
Re-submission Letters ................................................................................... 85
Re-configuration Letters ................................................................................ 86
Letters of Thanks for an Invitation to Publish an Article in a Journal
Asking About the Status of a Paper
Other Letters .................
In Summary ................................................................................................... 92
Unit V
Attending an International Radiological Course
Introduction ............................................
Travel and Hotel Arrangements
Course Example ............
Unit VI
Giving a Radiological Talk
Dos and Don’ts .....................................
Useful Sentences for Radiological Talks
The Dreadful Questions and Comments Section ...
Unit VII
Chairing a Radiological Session
Usual Chairperson’s Comments ................................................................. 127
Should Chairpersons Ask Questions? ........................................................ 130
What the Chairperson Should Say when Something is Going Wrong
Specific Radiological Chairperson’s Comments ....................................... 132
Usual Mistakes Made by Radiologists Speaking
and Writing in English
Misnomers and False Friends ...............................
Common Grammatical Mistakes .............................
Common Spelling Mistakes ................................
Common Pronunciation Mistakes ............................
Unit IX
Latin and Greek Terminology
Introduction ............................................ 149
Plural Rules ............................................ 151
List of Latin and Greek Terms and Their Plurals ................ 152
Unit X
Acronyms and Abbreviations
Introduction ............. .............................. 179
Abbreviation Lists .......................................
Exercises: Common Sentences Containing Abbreviations
Unit XI
Describing a Lesion
Describing Anatomical Relationships .......
Describing Radiological Findings: Word Order
Describing Focal Lesions ................
Unit XII
Standard Normal Reports
Standard Reports ...................
Your First Radiological Reports in English
Reporting in English
Usual Expressions Used in Reporting
Dictating a Radiological Report ....
Unit XIV
interventional Radiology
Introduction ............................................
Garments ..............................................
Tools and Devices .......................................
Talking to the Patient ...... ...............
Talking to the Patient’s Family ...............
Teaching Residents ........................
Talking to Nurses .........................
Talking to Technologists ....................
The IR’s Angiographic Equipment ............
Some Common “On Call” Orders for Nurse Units
Unit XV
On Call
Common On-Call Sentences ................................ 263
On-Call Conversations ....................................
Additional Call Terms ....................................
Unit XVI
Radiological Management
Commonly Used Phrases .............................
Big Questions, Easy Answers
Glossary ................
Radiological Conversation Guide
Conversational Abbreviations ..........................
Conversational Acronyms ............
Made-Up Words/Definitions/Expressions
Conversational Scenarios
Basic Communication Skills in Medicine
Greeting and Introducing Yourself ...
Invitation to Describe Symptoms
Instructions for Undressing ........
Instructions for Position on Couch . .
Instructions to Get Dressed ...........................
No Treatment ......................................
Questions and Commands ............................
Common Symptom Areas ...........
Key Words About Symptoms and Signs
Patient Examination ...............
Unit XIX
Conversation Survival Guide
Introduction ............................................
Greetings ..............................................
Personal Data ...........................................
Courtesy Sentences ..........
Speaking in a Foreign Language
At the Restaurant ...........
City Transportation ......................................
Cars ..................................................
Having a Drink (or Two)
On the Phone . .... ..
Emergency Situations
In the Bank .......
At the Police Station ......................................
Radiology resident at Brigham
and Women’s Hospital
Boston, MA, USA
Contributed to the preparation
of Units V, VIII, XII, XIII, XIV, XV,
Radiologist at INSCANNER
Alicante, Spain
Contributed to the preparation
of Unit III
Radiologist at Alto Guadalquivir
Andújar (Jaén), Spain
Contributed to the preparation
of Units II, III, V, XI, XII, XIII,
and XIX
Administration Dana Farber Cancer
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA, USA
Contributed to the preparation
of Unit XVI
Radiologist at Montilla Hospital
Montilla (Córdoba), Spain
Contributed to the preparation
of Units VI, VIII, IX, and X
Radiologist at Clínica Las Nieves
Jaén, Spain
Contributed to the preparation
of Unit IV
Radiology resident at Reina Sofia
Cordoba, Spain
Contributed to the preparation
of Units II, III, and V
Cardiovascular Surgeon at Carlos
Haya Hospital
Málaga, Spain
Contributed to the preparation
of Unit XVIII
Radiology resident at Reina Sofía
Córdoba, Spain
Contributed to the preparation
of Units IX, X, and XVII
Family doctor and ENT Consultant
at Reina Sofía Hospital
Córdoba, Spain
Drew the cartoons
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Unit I Methodological Approach
to Radiological English
The learning of radiological English is probably the most demanding of all
medical English by specialty. On the one hand, radiology covers the whole
anatomy, physiology and pathology of the body, so radiologists in the years
of residency, before getting involved in a radiological subspecialty, must be
familiar with virtually all medical English terminology; there is no other
specialty in which this happens. Cardiologists are not interested at all in
meniscal tears and orthopedic surgeons do not need to know a word about
arrhythmias (not even arrhythmia itself, which is one of the most frequently misspelled medical words). On the other hand, the multiplicity of
radiological subspecialties makes it extremely difficult, even for radiologists, to be familiar with the jargon of each subspecialty: an interventional
radiologist would be completely lost in a talk on mammography, and a
mammographer might not know the name of most interventional radiology devices.
A sound knowledge of English grammar is pivotal in order to build your
radiological English consistently. To be fluent in anatomical English is crucial for radiologists; we need to know what the normal structures look like
and are called, and how to express their relationships with radiological
findings. Anatomy is so linked to Latin and Greek that unless you are familiar with Latin and Greek terminology you will never be able to speak
and write either anatomical or radiological English properly. Besides, radiologists must be aware of the technical aspects of their subspecialties and
must be able to talk about them in an intelligible manner to patients, referring physicians, residents, nurses, and technicians.
Besides the technical medical language, the radiologist must understand
patients’ medical English which is the language used by patients talking
about their conditions. Both in ultrasound and interventional radiology,
patients talk about their conditions to the radiologists, but don’t forget
than in CT and MR units patients are interviewed by technologists who
must be aware of the usual expressions used by patients with regard to
their illnesses.
Unit I Methodological Approach to Radiological English
Let’s do a simple exercise. Read this sentence of radiological English:
1) Furthermore, ghost image artifacts arising from the intraluminal signal
can be used to prove the vascular nature of these lesions.
We are sure you understand the sentence and that you are able to translate
it into your own language almost instantly; unfortunately translation is not
only useless but deleterious to your radiological English with regard to fluency.
If you try to read the paragraph in English out-loud, your first difficulties
will appear.
If a conversation on the sentence starts and the audience is waiting for
your opinion, you may begin to sweat.
If you are not currently doing MR, “ghost artifact” (UK: artefact) may
mean nothing to you.
Check the words you are not able to pronounce easily and look them up in
the dictionary.
Ask an English-speaking colleague to read it aloud; try to write it; probably
you will find some difficulty in writing certain words.
Check the words you are not able to write properly and look them up in
the dictionary.
Finally, try to have a conversation on the topic.
Notice how many problems have been raised by just one sentence of radiological English. Our advice is that once you have diagnosed your actual radiological English level:
Do not get depressed if it is below your expectations.
Keep doing these exercises with progressively longer paragraphs beginning
with those belonging to your subspecialty.
Arrange radiological English sessions at your institution. A session once a
week might be a good starting point. The 5essions will keep you, and your
colleagues, in touch with at least a weekly radiological English meeting.
You will notice that you feel much more confident talking to colleagues
with a lower level than yours than talking to your native English teacher as
you will feel better talking to non-native English-speaking radiologists than
talking to native English-speaking colleagues. In these sessions you can rehearse the performance of talks and lectures so that when you give a presentation at an international meeting it is not the first time it has been delivered.
Let’s evaluate our radiological English level with these ten simple (?) exercises:
Are the following five sentences correct?
1. Baker’s cysts are hyperintense on T2.
The use of “-weighted image” after T1, T2, and PD is imperative since all
images contain T1, T2, and PD information, and we call sequences with regard to their predominant, although not exclusive, weighting. Therefore the
correct sentence is:
• Baker’s cysts are hyperintense on T2-weighted images.
2. The flexor digitorum long tendon is rarely involved with abnormalities.
The correct sentence is:
• The flexor digitorum longus tendon is rarely involved with abnormalities.
Always double-check Latin/Greek terminology spellings.
3. 57-years-old patient with severe abdominal pain.
The correct sentence is:
• 57-year-old patient with severe abdominal pain.
“57-year-old” is, in this case, an adjective, and adjectives, when they precede a name, cannot be written in the plural.
4. There was not biopsy of the lesion.
The correct sentence is:
• There was no biopsy of the lesion.
We could have said instead “there was not a biopsy of the lesion” or “there
was not any biopsy of the lesion”.
5. 87-year-old patient with arrythmia.
“Arrhythmia” is one of the most commonly misspelled words in medical
English. You can avoid this recurrent mistake by checking that the word
“rhythm” (provided it is spelled correctly!) is embedded in “arrhythmia”.
Unit I Methodological Approach to Radiological English
6. What does “window an image” mean?
To adjust the appropriate window and level settings.
7. What would you understand if in an interventional radiology suite you
hear: “Dance with me”?
Someone is asking to have his/her gown tied up.
8. Are “Harvard students” and “Harvard alumni” synonymous?
NO. The former term refers to current students and the latter to former
9. How would you ask a patient to perform a Valsalva maneuver?
Bear down as if you are having a bowel movement.
10. Are “home calls” and “in-house calls” synonymous?
NO. They are not synonymous but antonymous; they express opposite concepts. In “home calls” you will hopefully sleep at home, whereas in “inhouse calls” you must stay in the hospital for the whole clinical duty.
This set of questions is intended for those who think that radiological English is not worth giving a second thought to. On the one hand, most radiologists who have never worked in English-speaking hospitals tend to underestimate the difficulty of radiological English; they think that provided you
speak English you will not find any problems in radiological environments.
On the other hand, those who have suffered in their own skins embarrassing situations working abroad, do not dare say that either English or radiological English are easy.
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Unit II Radiological Grammar
The first chapters are probably the least read by most readers in general
and radiologists in particular, and in our opinion it is precisely in the first
chapters that the most important information of a book is displayed. It is
in its first chapters that the foundations of a book are laid, and many readers do not optimize the reading of a manual because they skip its fundamentals.
This is a vital chapter because unless you have a sound knowledge of
English grammar you will be absolutely unable to speak English as is expected from a well-trained radiologist. At your expected English level it is
definitely not enough just to be understood; you must speak fluently and
your command of the English language must allow you to communicate
with your colleagues regardless of their nationality.
As you will see immediately, this grammar section is made up of radiological sentences, so at the same time that you revise, for instance, the passive voice, you will be reviewing how to say usual sentences in day-to-day
radiological English such as “the CT scan had already been performed
when the Chairman arrived at the CT Unit”.
We could say, to summarize, that we have replaced the classical sentence
of old English manuals “my tailor is rich” by expressions such as “the first
year radiology resident is on call today”. Without a certain grammatical
background it is not pOS5ible to speak correctly just as without a certain
knowledge of anatomy it would not be possible to report on radiological
examinations. The tendency to skip both grammar and anatomy, considered by many as simple preliminary issues, has had deleterious effects on
the learning of English and radiology.
Te es
Talking About the Present
Present coiitinuors
Present continuous shows an action that is happening in the present time
at or around the moment of speaking.
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5imple present
Simple present shows an action that happens again and again (repeated action) in the present time, but not necessarily at the time of speaking.
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Unit II Radiological Grammar
— You should listen to Dr. Helms giving a conference. I am sure
you will love it.
- I bet the patient will recover satisfactorily after the reaction
following the administration of contrast material.
— I guess I will see you at the next annual meeting.
future Continuous
Will be + gerund of the verb.
• To say that we will be in the middle of something at a certain
time in the future:
— This time tomorrow morning I will be performing my first
• To talk about things that are already planned or decided (similar
to the present continuous with a future meaning):
— We can’t meet this evening. I will be stenting the aneurysm in
the patient we talked about.
• To ask about people's plans, especially when we want something
or want someone to do something (interrogative form):
- Wiii you be helping me dictate MR reports this evening?
future Perfect
Will have + past participle of the verb.
• To say that something will already have happened before a certain time in the future:
— I think the resident will already have arrived by the time we
begin the scrotal ultrasound.
— Next spring I will have been working for 25 years in the Radiology Department of this institution.
Talking About the Past
Simple Past
Past Continvovs
Unit II Radiological Grammar
Present Perfect
In the latter situation you can use the present perfect with the following
• Just (i.e., a short time ago): to say something has happened a short time
— Dr. Ho has just arrived at the hospital. He is our new pediatric radiologist.
• Already: to say something has happened sooner than expected:
— The second-year resident has already finished her presentation.
Remember that to talk about a recent happening we can also use the simple past:
• To talk about a period of time that continues up to the present (an unfinished period of time):
— We use the expressions: today, this morning, this evening, this week
— We often use ever and never.
• To talk about something that we are expecting. In this situation we use
yet to show that the speaker is expecting something to happen, but only
in questions and negative sentences:
— Dr. Helms has ROt Arrived yet.
• To talk about something you have never done or something you have
not done during a period of time that continues up to the present:
— I have not reported an MR scan of the knee since I was a resident.
• To talk about how much we have done, how many things we have done
or how many times we have done something:
— I have reported that regional brain perfusion scan twice because the
first report was lost.
— Dr. Yimou has performed twenty vertebroplasties this week.
• To talk about situations that exist for a long time, especially if we say always. In this case the situation still exists now:
— Gadolinium has always been the contrast agent used in MRI examinations.
— Dr. Olmedo has Olways been a very talented radiologist.
We also use the present perfect with these expressions:
• Superlative: It is the most ...:
— This is the most interesting neuroradiology case that I have ever Seen.
• The first (seCond, third ...) time ...:
— This is the first time that I have seen a CT of a vertebral hemangiopericytoma
Present Perfect Continvovs
Shows an action that began in the past and has gone on up to the present
Unit II Radiological Grammar
Past Perfect
Shows an action that happened in the past before another past action. It is
the past of the present perfect.
Past Perfect Continuous
Shows an action that began in the past and went on up to a time in the
past. It is the past of the present perfect continuous.
Imagine this situation:
• The surgeon says to the radiologist, “Why don’t you do a CT scan on
the patient with acute abdominal pain?”
• The surgeon proposes (that) the radiologist do a CT scan on the patient
with acute abdominal pain.
The subjunctive is formed always with the base form of the verb (the infinitive without to):
• I suggest (that) you work harder.
• She recommended (that) he give up smoking while dictating.
• He insisted (that) she perform an ultrasound examination on the patient
as soon as possible.
• He demanded (that) the nurse treat him more politely.
Note that the subjunctive of the verb fo be is usually passive:
• He insisted (that) the CT be dictated immediately.
You can use the subjunctive after:
Unit II Radiological Grammar
You can use the subjunctive for the past, present or future:
• He suggested (that) the resident change the treatment.
• He reCommends (that) his patients give up smoking.
Should is sometimes used instead of the subjunctive:
• The doctor recommended that I should have an MRI examination; he
suspects that my meniscus is probably torn.
¥lish, If Only, IiIfouId
• Wish + simple past. To say that we regret something (i.e., that something is not as we would like it to be) in the present:
- I wish I were not on call tomorrow (but I am on call tomorrow).
• Wish + past perfect. To say that we regret something that happened or
didn’t happen in the past:
- I wish he hadn’t treated the patient’s family so badly (but he treated
the patient’s family badly).
• Wish + would + infinitive without to when we want something to happen or change or somebody to do something:
- I wish you wouldn’t dictate so slowly (note that the speaker is complaining about the present situation or the way people do things).
If Only
If only can be used in exactly the same way as wish. It has the same meaning as wish but is more dramatic:
• If only + past simple (expresses regret in the present):
— If only I were not on call tomorrow.
• If only + past perfect (expresses regret in the past):
- If only he hadn’t treated the patient’s family so badly.
After wish and if only we use were (with I, he, she, if) instead of was, and
we do not normally use would, although sometimes it is possible, or would
When referring to the present or future, wish and if only are followed by
a past tense, and when referring to the past by a past perfect tense.
Would is used:
• As a modal verb in offers, invitations and requests (i.e., to ask someone
to do something):
— Would you help me to write an article on hepatic cholangiocarcinoma? (request).
Modal Verbs
- Would you like to come to the residents’ party tonight? (offer and invitation).
• After wish (see Wish).
• In if sentences (see Conditionals).
• Sometimes as the past of will (in reported speech):
— Dr. Smith: I will do your bladder ultrasound next week.
— Patient: The doctor said that he would do my bladder ultrasound next
• When you remember things that often happened (similar to used to):
— When we were residents, we used to prepare the clinical cases together.
— When we were residents, we would prepare the clinical cases together.
Modal Verbs
Unit II Radiological Grammar
Expressing Ability
To express ability we can use:
• Can (only in the present tense)
• Could (only in the past tense)
• Be able to (in all tenses)
Ability in the Present
Can (more usual) or am/ lS/ are able to (less usual):
Dr. Williams can stent on extremely difficult mesenteric artery stenosis.
Dr. Rihsnah iS able to dilate esophagic stenosis in children.
Can you speak medical English? Yes, I can.
Are you able to speak medical English? Yes, I am.
Ability in the Past
Could (past form of can) or was/ were able to.
We use Could to say that someone had the general ability to do something:
• When I was a resident I could speak German.
We use was/ were able to to say that someone managed to do something in
one particular situation (specific ability to do something):
• When I was a resident I was able to do fifteen duties in one month.
Managed to can replace was able to:
• When I was a resident I managed to do fifteen duties in one month.
We use could have to say that we had the ability to do something but we
didn’t do it:
• He could have been a surgeon but he became a radiologist instead.
Sometimes we use Could to talk about ability in a situation which we are
imagining (here could —— would be able to):
• I couldn’t do your job. I’m not clever enough.
We use will be able to to talk about ability with a future meaning:
• If you keep on studying radiological English you will be able to write articles for RadiographicS very soon.
Modal Verbs
Expressing Necessity
Necessity means that you cannot avoid doing something.
To say that it is necessary to do something we can use must or have to.
• Necessity in the present: must, have/has to.
• Necessity in the past: had to.
• Necessity in the future: must or will have to.
Notice that to express necessity in the past we do not use must.
There are some differences between must and have to:
• We use must when the speaker is expressing personal feelings or authority, saying what he or she thinks is necessary:
— Your chest X-ray film shows severe emphysema. You must give up
• We use have to when the speaker is not expressing personal feelings or
authority. The speaker is just giving facts or expressing the authority of
another person (external authority), often a law or a rule:
— All radiology residents have to learn how to dictate the different types
of imaging examinations in their first year of residency.
If we want to express that there is necessity to avoid doing something, we
use mustn’t (’i.e., not allowed to):
• You mustn’t eat anything before the intravenous administration of contrast agent.
Expressing No Necessity
To express that there is no necessity we can use the negative forms of need
or have to:
• No necessity in the present: needn’t or don’t/doesn’t have to.
• No necessity in the past: didn’t need, didn’t have to.
• No necessity in the future: won’t have to.
Notice that “there is no necessity to do something” is completely different
from “there is a necessity not to do something”.
In conclusion, we use mustn’t when we are not allowed to do something or
when there is a necessity not to do it, and we use the negative form of
have to or needn’t when there is no necessity to do something but we can
do it if we want to:
Unit II Radiological Grammar
• The radiologist says I mustn’t get overtired before the procedure but I
needn’t stay in bed.
The radiOlogist says I mustn t get overtired before the procedure but i
don’t have to stay in bed.
Expressing Possibility
To express possibility we can use Can, could, may or might (from more to
less certainty: can, may, might, could).
But also note that “can” is used of ability (or capacity) to do something;
“may” of permission or sanction to do it.
Possidi/ity in the Present
To say that something is possible we use can, may, might, could:
• High doses of radiation can cause you to get cancer (high level of certainty).
• Radiation may actually cause you to get cancer (moderate to high level
of certainty).
• Radiation might cause you to get thyroid cancer (moderate to low level
of certainty).
• Radiation could cause you to get an osteosarcoma (low level of certainty).
Possihiiity in the Past
To say that something was possible in the past we use may have, might
have, Could have:
• The lesion might have been detected on CT if the slice thickness had
been thinner.
Could have is also used to say that something was a possibility or opportunity but it didn’t happen:
• You were lucky to be treated with coil embolization, otherwise you could
have died.
I COHldn’t have done something (i.e., I wouldn’t have been able to do it if I
had wanted or tried to do it):
• She couldn’t have seen that mediastinal lesion on the chest X-ray anyway,
because it was extremely small.
Modal Verbs
Possidi/ity in the future
To talk about possible future actions or happenings we use may, might,
could (especially in suggestions):
• I don’t know where to do my last six months of residency. I may/might
go to the States.
• We could meet later in the hospital to write the article, couldn’t we?
When we are talking about possible future plans we can also use the continuous form may/might/could be + -ing form:
• I could be going to the next RSNA meeting.
Expressing Certainty
To say we are sure that something is true we use must:
• You have been reporting all night. You must be very tired (i.e., I am sure
that you are tired).
To say that we think something is impossible we use can’t:
• According to his clinical situation and imaging studies, that diagnosis
can’t be true (i.e., I am sure that that diagnosis is not true).
For past situations we use must have and can’t have. We can also use
couldn’t have instead of can’t have:
• Taking into consideration the situation, the family of the patient Couldn’t
have asked for more.
Remember that to express certainty we can also use will:
• The double-contrast upper gastrointestinal tract protocol wifi vary from
institution to institution.
Expressing Permission
To talk about permission we can use can, may (more formal than can) or
be allowed to.
Permission in the Present
Can, may or amfis/are allowed to:
• You can smoke if you like.
• You are allowed fo smoke.
• You may attend the Congress.
Unit II Radiological Grammar
Permission in the Past
Was/ were allowed to:
• Were you allowed to go into the interventional radiology suite without
surgical scrubs?
Permission in the Future
Will be allowed to:
• I will be allowed to leave the hospital when my duty is finished.
To ask for permission we use Can, may, could or might (from less to more
formal) but not be allowed to:
• Hi Hannah, COn I borrow your digital camera? (if you are asking for a
friend’s digital camera).
• Dr. Ho, may I borrow your digital camera? (if you are talking to an acquaintance).
• Could I use your digital camera, Dr. Coltrane? (if you are talking to a
colleague you do not know at all).
• Might I use your digital camera, Dr. De Roos? (if you are asking for the
chairman’s digital camera).
Expressing Obligation or Giving Advice
Obligation means that something is the right thing to do.
When we want to say what we think is a good thing to do or the right
thing to do we use should or ought to (a little stronger than should).
Should and ought to can be used for giving advice:
You ought to sleep.
You should work out.
You ought to give up smoking.
Should he see a doctor? Yes, I think he should.
Conditional sentences have two parts:
1. “If-clause”
2. Main clause
In the 5entence “If I were you I would go to the annual meeting of radiology residents”, “If I were you” is the if-clause, and “I would go to the annual meeting of radiology residents” is the main clause.
The if-clause can come before or after the main clause. We often put a
comma when the if-clause comes first.
Main Types of Conditional Sentences
To talk about things that always are true (general truths).
If + simple present + simple present:
• Jf you inject intravenous contrast material, the vessels show high density
on a CT scan.
• /f you see free air in the abdomen, the patient is perforated.
• /f you drink too much alcohol, you get a sore head.
• Jf you take drugs habitually, you become addicted.
Note that the examples above refer to things that are normally true. They
make no reference to the future; they represent a present simple concept.
This is the basic (or classic) form of the conditional type 0.
There are possible variations of this form. In the if-clause and in the
main clause we can use the present continuous, present perfect simple or
present perfect continuous instead of the present simple. In the main
clause we can also use the imperative instead of the present simple:
• Residents only get a certificate if they have attended the course regularly.
So the type 0 form can be reduced to:
• If + present form + present form or imperative.
Present forms include the present simple, present continuous, present perfect simple, and present perfect continuous.
To talk about future situations that the speaker thinks are likely to happen
(the speaker is thinking about a real possibility in the future).
If + simple present + future simple (will):
• If I find something new about the percutaneous treatment of malignant
obstructive jaundice, I will tell you.
Unit II Radiological Grammar
• If we analyze contrast agents, we will be able to infer laws and principles
about their effect over renal function.
These examples refer to future things that are possible and it is quite probable that they will happen. This is the basic (or classic) form of the conditional type 1.
There are possible variations of the basic form. In the if-clause we can
use the present continuous, the present perfect or the present perfect continuous instead of the present simple. In the main clause we can use the
future continuous, future perfect simple or future perfect continuous instead of the future simple. Modals such as can, may or might are also possible.
So the form of type 1 can be reduced to:
• If + present form + future form
Future forms include the future simple, future continuous, future perfect
simple, and future perfect continuous.
To talk about future situations that the speaker thinks are possible but not
probable (the speaker is imagining a possible future situation) or to talk
about unreal situations in the present.
If + simple past + conditional (would):
• Peter, if you studied harder, you would be better prepared for doing your
CAQ in neuroradiology.
The above sentence tells us that Peter is supposed not to be studying hard.
• If I were you, I would go to the Annual Meeting of Interventional Radiology (but I am not you).
• If I were a resident again I would go to Harvard Medical School for a
whole year to complete my training period (but I am not a resident).
There are possible variations of the basic form. In the if-clause we can use
the past continuous instead of the past simple. In the main clause we can
use Could or might instead of would.
So the form of type 2 can be reduced to:
• If + past simple or continuous + would, could or might.
To talk about past situations that didn’t happen (impossible actions in the
If + pa5t perfect + perfect conditional (would have):
• If I had known the patient’s symptoms, I would probably have not
missed the small pancreatic lesion on the CT scan.
As you can see, we are talking about the past. The real situation is that I
didn’t know the patient’s symptoms so that I didn’t notice the small pancreatic lesion.
This is the basic (or classic) form of the third type of conditional. There
are possible variations. In the if-clause we can use the past perfect continuous instead of the past perfect simple. In the main clause we can use the
continuous form of the perfect conditional instead of the perfect conditional simple. Would probably, could or might instead of would are also
possible (when we are not sure about something).
In Case
“The interventional radiologist wears two pairs of latex gloves during an
intervention in case one of them tears'’ In case one of them tears because it
is possible that one of them tears during the intervention (in the future).
Note that we don’t use will after in Case. We use a present tense after in
case when we are talking about the future.
In case is not the same as if. Compare these sentences:
• We’ll buy some more food and drink if the new residents come to our
department’s party. (Perhaps the new residents will come to our party.
If they come, we will buy some more food and drink; if they don’t come,
we won’t.)
• We will buy some food and drink in case the new residents come to our
department’s party. (Perhaps the new residents will come to our department’s party. We will buy some more food and drink whether they come
or not.)
We can also use in case to say why someone did something in the past:
• He rang the bell again in Case the nurse hadn’t heard it the first time.
(Because it was possible that the nurse hadn’t heard it the first time.)
In case of (= if there is):
• In ca5e of pregnancy, don’t have an X-ray examination.
“Don't take these pills unless you are extremely anxious.” (Don’t take these
pills except if you are extremely anxious.) This sentence means that you
can take the pills only if you are extremely anxious.
Unit II Radiological Grammar
We use unless to make an exception to something we say. In the example
above the exception is you are extremely anxious.
We often use unless in warnings:
• Unless you send the application form today, you won’t be accepted in the
next National Congress of Radiology.
It is also possible to use if in a negative sentence instead of unless:
• Don’t take those pills if you aren’t extremely anxious.
• If you don t Send the application form today, you won’t be accepted in
the next Congress of Radiology.
As Long As, Provided (That), Providing (That)
These expressions mean but only if:
• You can use my new pen to sign your report as long as you write carefully (i.e., but only if you write carefully).
• Going by car to the hospital is convenient provided (that) you have
somewhere to park (i.e., flat only if you have somewhere to park).
• Providing (that) she studies the clinical cases, she will deliver a bright
Passive Voice
Study these examples:
• The first ultrasound examination was performed at our hospital in 1980
(passive sentence).
• Someone performed the first ultrasound examination at our hospital in
1980 (active sentence).
Both sentences are correct and mean the same. They are two different ways
of saying the same thing, but in the passive sentence we try to make the
object of the active sentence (“the first ultrasound examination”) more important by putting it at the beginning. So, we prefer to use the passive
when it is not that important who or what did the action. In the example
above, it is not so important (or not known) who performed the first ultrasound examination.
Active sentence:
• Fleming (subject) discovered (active verb) penicillin (object) in 1950.
Passive sentence:
• Penicillin (subject) was discovered (passive verb) by Fleming (agent) in
The passive verb is formed by putting the verb to be into the same tense
as the active verb and adding the past participle of the active verb:
• Discovered (active verb) — was discovered (be + past participle of the
active verb).
The object of an active verb becomes the subject of the passive verb (“penicillin”). The subject of an active verb becomes the agent of the passive
verb (“Fleming”). We can leave out the agent if it is not important to mention it or we don’t know it. If we want to mention it, we will put it at the
end of the sentence preceded by the particle by (“... by Fleming”).
Some sentences have two objects, indirect and direct. In these sentences
the passive subject can be either the direct object or the indirect object of
the active sentence:
• The doctor gave the patient a new treatment.
There are two possibilities:
• A new treatment was given to the patient.
• The patient was given a new treatment.
Passive Forms of Present and Past Tenses
Simple Present
• Radiologists review the most interesting cases in the clinical session
every day.
• The most interesting cases are reviewed in the clinical session every day.
Simple Past
• The nurse checked the renal function of the patient before the CT examination.
• The renal function of the patient was checked before the CT examination.
Unit II Radiological Grammar
Present Continvovs
• Dr. Golightly is reporting an intravenous urogram right now.
• An intravenous urogram is being reported right now.
Past Coiitinrors
• They were carrying the injured person to the CT room.
• The injured person was being carried to the CT room.
Present Perfect
• The radiologist has performed ten lower-extremity Doppler ultrasounds
this morning.
• Ten lower-extremity Doppler ultrasounds have been performed this
Past Perfect
• They had sent the CT films before the operation started.
• The CT films had been sent before the operation started.
In sentences of the type “people say/consider/know/think/believe/expect/
understand ... that ...”, such as “Doctors consider that AIDS is a fatal disease”, we have two possible passive forms:
• AIDS is considered to be a fatal disease.
• It is considered that AIDS is a fatal disease.
Have/Get Something Done
Reported Speech
Get i5 a little more informal than have, and it is often used in informal
spoken English:
• You should get your ultrasound machine tested.
• You should have your ultrasound machine tested.
When we want to say that we don’t want to do something ourselves and we
arrange for someone to do it for us, we use the expression have something
• The patient had all his metal objects removed in order to prevent accidents during the MR examination.
Sometimes the expression have something done has a different meaning:
• John had his knee broken playing a football match. MRI showed a meniscal tear.
It is obvious that this doesn’t mean that he arranged for somebody to
break his knee. With this meaning, we use have 5omething done to say that
something (often something not nice) happened to someone.
Supposed To
Supposed to can be used in the following ways:
Can be used like Said to:
• The chairman is supposed to be the one who runs the department.
To say what is planned or arranged (and this is often different from what
really happens):
• The fourth year resident is supposed to read this CT.
To say what is not allowed or not advisable:
• She was not supposed to be on call yesterday.
Reported Speech
Imagine that you want to tell someone else what the patient said. You can
either repeat the patient’s words or use reported speech.
The reporting verb (said in the examples below) can come before or
after the reported clause (there was a Conference about cardloC MR that
evening), but it usually comes before the reported clause. When the reporting verb comes before, we can use that to introduce the reported clause or
we can leave it out (leaving it out is more informal). When the reporting
verb comes after, we cannot use that to introduce the reported clause.
Unit II Radiological Grammar
The reporting verb can report statements and thoughts, questions, orders, and requests.
Reporting in the Present
When the reporting verb is in the present tense, it isn’t necessary to
change the tense of the verb:
“I’ll help you guys with this esophagogram”, he says.
He says (that) he will help us obtain this esophagogram.
“The vertebroplasty will take place this morning”, he says.
He says (that) the vertebroplasty will take place this morning.
Reporting in the Past
When the reporting verb is in the past tense, the verb in direct speech
usually changes in the following ways:
Simple present changes to simple past.
Present continuous changes to past continuous.
Simple past changes to past perfect.
Past continuous changes to past perfect continuous.
Present perfect changes to past perfect.
Present perfect continuous changes to past perfect continuous.
Past perfect stays the same.
Future changes to conditional.
Future continuous changes to conditional continuous.
Future perfect changes to conditional perfect.
Conditional stays the same.
Present forms of modal verbs stay the same.
Past forms of modal verbs stay the same.
Pronouns, adjectives and adverbs also change. Here are some examples:
First person singular changes to third person singular.
Second person singular changes to first person singular.
First person plural changes to third person plural.
Second person plural changes to first person plural.
Third person singular changes to third person plural.
Now changes to then.
Today changes to that day.
Tomorrow changes to the day after.
Yesterday changes to the day before.
This changes to that.
Here changes to there.
Ago changes to before.
Reported Speech
It is not always necessary to change the verb when you use reported
speech. If you are reporting something and you feel that it is still true, you
do not need to change the tense of the verb, but if you want you can do it:
• The treatment of choice for severe urticaria after intravenous contrast
administration is epinephrine.
• He said (that) the treatment of choice for severe urticaria after intravenous contrast administration is epinephrine.
• He said (that) the treatment of choice for severe urticaria after intravenous contrast administration was epinephrine.
Reporting Questions
Yes and to questions
We use whether or if:
Do you smoke or drink any alcohol?
The doctor asked if I smoked or drank any alcohol.
Have you had any urticaria after intravenous contrast injections?
The doctor asked me whether I had had any urticaria after intravenous
contrast injections or not.
• Are you taking any pills or medicines at the moment?
• The doctor asked me if I was taking any pills or medicines at that moment.
¥Ih ... questions
We use the same question word as in the wñ ... question:
What do you mean by saying you are feeling under the weather?
The doctor asked me what I meant by saying I was feeling under the weather.
Why do you think you feel under the weather?
The doctor asked me why I thought I felt under the weather.
When do you feel under the weather?
The doctor asked me when I felt under the weather.
How often do you have headaches?
The doctor asked how often I had headaches.
Reported Questions
Reported questions have the following characteristics:
• The word order is different from that of the original question. The verb
follows the subject as in an ordinary statement.
Unit II Radiological Grammar
• The auxiliary verb do is not used.
• There is no question mark.
• The verb changes in the same way as in direct speech.
Study the following examples:
• How old are you?
• The doctor asked me how old I was.
• Do you smoke?
• The doctor asked me if I smoked.
Reporting Orders and Requests
Reporting Suggestions and Advice
Suggestions and advice are reported in the following forms:
• Suggestions
— Why don’t we operate on that patient this evening?
— The surgeon suggested operating on that patient that evening.
• Advice
— You had better stay in bed.
— The doctor advised me to stay in bed.
In sentences with to be, to have (in its auxiliary form) and modal verbs,
we usually make questions by changing the word order:
• Affirmative
— You are a radiologist.
— Interrogative: Are you a radiologist?
• Negative
— You are not a radiologist.
— Interrogative: Aren’t you a radiologist?
In simple present questions we use do/ does:
• His stomach hurts after having barium for upper GI examination.
• Does his stomach hurt after having barium for upper GI examination?
In simple past questions we use did:
• The nurse arrived on time.
• Did the nurse arrive on time?
If whO/ what/whiCh is the subject of the sentence we do not use do:
• Someone paged Dr. W.
• Who paged Dr. W?
If who/what/which is the object of the sentence we use did:
• Dr. W. paged someone.
• Who did Dr. W. page?
When we ask somebody and begin the question with Do you know ... or
Could you tell me ... , the rest of the question maintains the affirmative
sentence’s word order:
• Where is the reading room?
• Do you know where the reading room is?
• Where is the library?
• Could you tell me where the library is?
Reported questions also maintain the affirmative sentence’s word order:
• Dr. Wilson asked: How are you?
• Dr. Wilson asked me how I was.
Short answers are possible in questions where be, do, CaTI, have and might
are auxiliary verbs:
• Do you smoke? Yes, I do.
• Did you smoke? No, I didn’t.
• Can you walk? Yes, I can.
We also use auxiliary verbs with so (affirmative) and neither or nor (negative) changing the word order:
• I am feeling tired. So am I.
• I can’t remember the name of the disease. Neither can I.
• Is he going to pass the boards? I think so.
Unit II Radiological Grammar
• Will you be on call tomorrow? I guess not.
• Will you be off call the day after tomorrow? I hope so.
• Has the Chairman been invited to the party? I’m afraid so.
Tag questions
We use a positive tag question with a negative sentence and vice versa:
• The first year resident isn’t feeling very well today, is she?
• You are working late at the lab, aren’t you?
After let S the tag question is shall we!
• Let’s read a couple of articles, shall we?
After the imperative, the tag question is will you!
• Turn off the viewer, will you?
Verb + -Ing
There are certain verbs that are usually used in the structure verb + -ing
when followed by another verb:
• Stop: Please stop talking.
* FlHlSh: I’ve finished translating the article into English.
• Enjoy: I enjoy talking to patients while I’m doing an ultrasound on
• Mind: I don’t mind being told what to do.
• Suggest: Dr. Knight Suggested going to the OT and trying to operate on
the aneurysm that we couldn’t stent.
• DlSlike: She dislikes going out late after a night on-call.
• Imagine: I can’t imagine you operating. You told me you hate blood.
• Regret: He regrets having gone two minutes before his patient had seizures.
• Admit: The resident admitted forgetting to report Mrs. Smith's mammography.
• Consider: Have you considered finishing your residence in the USA?
Other verb5 that follow this structure are: avoid, deny, involve, practice,
TIIISS, pOS tpone, and risk.
The following expressions also take -ing:
• Give up: Are you going to give up smoking!
• Keep on: She kept on interrupting me while I was 5peaking.
• Go on: Go on studying, the exam will be next month.
When we are talking about finished actions, we can also use the verb to
• The resident admitted forgetting to report Mrs. Smith’s mammography.
• The resident admitted having forgotten to report Mrs. Smith’s mammography.
And, with some of these verbs (admit, deny, regret and suggest), you also
can use a “that ...” structure:
• The resident admitted forgetting to report Mrs. Smith’s mammography.
• The resident admitted that he had forgotten to report Mrs. Smith’s mammography.
Verb + Infinitive
When followed by another verb, these verbs are used with verb + infinitive
Agree: The patient agreed to give up smoking.
Refuse: The patient refused to give up smoking.
PromiSe: I promised to give up smoking.
Threaten: Dr. Sommerset threatened to close the radiology department.
Offer: The unions offered to negotiate.
Decide: Dr. Knight’s patients deCided to leave the waiting room.
Other verbs that follow this structure are: attempt, manage, fail, plan, arrange, afford, forget, learn, dare, tend, appear, seem, pretend, need, and intend.
There are two possible structures after these verbs: wall, ask, expect, help,
would like, and would prefer:
• Verb + infinitive: I asked to See Dr. Knight, the surgeon who operated on
my patient.
• Verb + object + infinitive: I asked Dr. Knight to inform me about my patient.
There is only one possible structure after the following verbs: tell, order, remind, warn, forCe, invite, enable, teaCh, persuade, and get:
• Verb + object + infinitive: Remind me to report those radiographs tomorrow before 10 a.m.
Unit II Radiological Grammar
There are two possible structures after the following verbs:
• Advise:
— I wouldn’t advise learning at that radiology department.
— I wouldn’t advise you to learn at that radiology department.
• Allow:
— They don’t aHOW SiTlOking in the CT room.
— They don’t allow you to smoke in the CT room.
• Permit:
— They don’t permit eating in the radiology reading room.
— They don’t permit you to eat in the radiology reading room.
When you use make and let, you should use the structure: verb + base
form (instead of verb + infinitive):
• Blood makes me feel dizzy (you can’t say: blood makes me to feel ...).
• Dr. Knight wouldn’t let me stent on his patient.
After the following expressions and verbs you can use either -ing or the infinitive: like, hate, love, can’t stand, and can’t bear:
• She can’t stand being alone while she is performing an ultrasound examination.
• She Can t stond to be alone while she is performing an ultrasound examination.
After the following verbs you can use -ing but not the infinitive: dislike, enjoy, and mind:
• I enjoy being alone (not: I enjoy to be alone).
Would like, a polite way of saying I want, is followed by the infinitive:
• Would you like to be the chairman of the neuroimaging division?
Begin, start and continue can be followed by either -ing or the infinitive:
• The patient began to improve after the percutaneous drainage of his collection.
• The patient began improving after the percutaneous drainage of his collection.
With some verbs, such as remember and fry, the use of -ing and infinitive
after them have different meanings:
• Remember:
— I did not remember to place the tip of the catheter at the IVC before
starting the contrast injection (I forgot to place the catheter properly).
- I could remember (myself) placing the tip of a catheter at the IVC that
day (I can recall placing the catheter).
• Try:
— The patient tried to keep her eyes open while the MR examination
was going on.
— If your headache persists, try asking for a MRI.
Verb + Preposition + -Ing
If a verb comes after a preposition, that verb ends in -ing:
• Are you interested in working for our hospital?
• What are the advantages of developing new radiological techniques?
• She S not very good at learning languages.
You can use -ing with before and after.
• Discharge Mr. Brown before operating on the aneurysm.
• What did you do after finishing your residence?
You can use fit + -ing to explain how something happened:
• You can improve your medical English by reading scientific articles.
You can use -ing after without:
• Jim got to the hospital without realizing he had left his locker keys at
Be careful with to because it can either be a part of the infinitive or a preposition:
• I’m looking forward to see you again (this is NOT correct).
• I’m looking forward to seeing you again.
• I’m looking forward to the next European congress.
Review the following verb + preposition expressions:
• succeed in finding a job
• feel like going out tonight
• fhink nbouf operating on that patient
• dream of being a radiologist
• disapprove of smoking
• look forward to hearing from you
• insist on inviting me to chair the session
• apologize for keeping Dr. Ho waiting
• aCcuSe (someone) of telling lie5
suspected of having AIDS
stop from leaving the ward
thank (someone) for being helpful
forgive (someone) for not writing to me
warn (someone) against carrying on smoking
Unit II Radiological Grammar
The following are some examples of expressions + -ing:
I don’t feel like going out tonight.
It’s no use trying to persuade her.
There’s no point in waiting for him.
It’s not worth taking a taxi. The hospital is only a short walk from here.
It’s worth looking again at that radiograph.
I am having difficulty reporting that T-tube cholangiogram
I rim having trouble reporting that T-tube cholangiogram.
Countable and Uncountable Nouns
Mountable Nouns
Countable nouns are things we can count. We can make them plural.
Before singular countable nouns you may use o/as:
• You will be attended to by a radiologist.
• Dr. Vida is looking for rim anesthetist.
Remember to use a/an for jobs:
• I’m n radiologist.
Before plural countable nouns you use some as a general rule:
• I’ve read some good articles on spiral chest CT lately.
Don’t use some when you are talking about general things:
• Generally speaking, I like radiology books.
You have to use some when you mean some, but not all:
• Some doctors carry a stethoscope but radiologists don’t.
Uncountable Nouns
Uncountable nouns are things we cannot count. They have no plural.
You cannot use a/as before an uncountable noun; in this case you have to
use the, Some, any, muCh, thls, his, etc ... or leave the uncountable noun
alone, without the article:
• The chairman gave me an advice (NOT correct).
• The chairman gave me some advice.
Many nouns can be used as countable or uncountable nouns. Usually there
is a difference in their meaning:
Articles: Infinitive/-/rip
AlAn and The
• I had many experiences on my rotation at the Children’s Hospital (countable).
• I need experience to become a good radiologist (uncountable).
Some nouns are uncountable in English but often countable in other
languages: adviCe, baggage, behavior, bread, chaos, furniture, information,
luggage, news, permission, progress, scenery, tYoffic, travel, trouble, and
Articles: 4/dll and The
The speaker says a/rim when it is the first time he talks about something,
but once the listener knows what the speaker is talking about, he says the:
• This morning I did rim ultrasound and n chest plain film. The ultrasound was completely normal.
We use the when it is clear which thing or person we mean:
• Can you turn off the light.
• Where is the radiology chest division, please?
As a general rule, we say:
The police
The bank
The post office
The fire department
The doctor
The hospital
The dentist
We say: the sea, the sky, the ground, the city, and the country.
We don’t use the with the names of meals:
• What did you have for lunch/breakfast/dinner?
But we use n when there is an adjective before a noun:
• Thank you. It was a delicious dinner.
We use fhe for musical instruments:
• Can you play the piano?
We use the with absolute adjectives (adjectives used as nouns). The meaning is always plural. For example:
Unit II Radiological Grammar
The rich
The old
The blind
The sick
The disabled
The injured
The poor
The young
The deaf
The dead
The unemployed
The homeless
We use the with nationality words (note that nationality words always begin with a capital letter):
• The British, the Dutch, fhe Spanish.
We don’t use the before a noun when we mean something in general:
• I love doctors (not the doctors).
With the words school, college, prison, jail, church we use the when we
mean the buildings and leave the substantives alone otherwise. We say: go
to bed, go to work and go home. We don’t use the in these cases.
We use the with geographical names according to the following rules:
• Continents don’t use the:
— Our new resident comes from Asia.
• Countries/states don’t use the:
— The patient that underwent a liver duplex ultrasound came from Sweden.
(except for country names that include words such as Republic, Kingdom, States ... ; e.g., the United States of America, the United Kingdom,
and The Netherlands).
As a general rule, cities don’t use the:
• The next Radiology Congress will be held in Zaragoza.
Islands don’t use the with individual islands but do use it with groups:
• Dr. Holmes comes from Sicily and her husband from the Canary Islands.
Lakes don’t use the,- oceans, seas, rivers and canals do use it.
• Lake Windermere is beautiful.
• The Panama canal links the Atlantic ocean to the Pacific ocean.
Word Order
We use the with streets, building5, airports, universities, etc, according to
the following rules:
• Streets, roads, avenues, boulevards and squares don’t use the:
— The hospital is sited at 15th. Avenue.
• Airports don’t use the:
— The plane arrived at JFK airport
• We use the before publicly recognized buildings: the White House, the
Empire State Building, the Louvre museum, the Prado museum.
• We use the before names with of: the Tower of London, the Great Wall
of China.
• Universities don’t use the: I studied at Harvard.
Word Order
The order of adjectives is discussed in the section Adjectives under the
heading Adjective Order
The verb and the objeCt of the verb normally go together:
• I studied radiology because I like watching images very much (not I like
very much watching images).
We usually say the place before the time:
• She has been practicing interventional radiology in London since April.
We put some adverbs in the middle of the sentence:
If the verb is one word we put the adverb before the verb:
• I performed his carotid duplex ultrasound and a ISO Spoke to his family.
We put the adverb after to be:
• You are nfwnJs on time.
We put the adverb after the first part of a compound verb:
• Are you definitely attending the musculoskeletal radiology course?
In negative sentences we put probably before the negative:
• I probably won’t see you at the congress.
We also use nil and both in these positions:
• Jack and Tom are both able to carry out a carotid angiogram.
• We all felt sick after the meal.
Unit II Radiological Grammar
Relative Clauses
A clause is a part of a sentence. A relative clause tells us which person or
thing (or what kind of person or thing) the speaker means.
A relative clause (e.g. who is on call?) begins with a relative pronoun
(e.g. who, that, which, whose).
A relative clause comes after a noun phrase (e.g. the doctor, the nurse).
Most relative clauses are defining clauses and some of them are non-defining clauses.
Defining Clauses
• The book on interventional radiolog y (that) you lent me is very intereStThe relative clause is essential to the meaning of the sentence.
Commas are not used to separate the relative clause from the rest of the
That is often used instead of who or which, especially in speech.
If the relative pronoun is the object (direct object) of the clause, it can
be omitted.
If the relative pronoun is the subject of the clause, it cannot be omitted.
Non-Defining Clauses
• The first vertebral angiogram in Australia, which took place at our hospital, was a complete success.
The relative clause is not essential to the meaning of the sentence; it gives
us additional information.
Commas are usually used to separate the relative clause from the rest of
the sentence.
That cannot be used instead of who or which.
The relative pronoun cannot be omitted.
Relative Pronouns
Relative pronouns are used for people and for things.
• For people:
— Subject: who, that
— Object: who, that, whom
— Possessive: whose
• For things:
— Subject: which, that
— Object: which, that
— Possessive: whose
Who is used only for people. It can be the subject or the object of a relative
• The patient who was admitted in a shock situation is getting better. Can
we perform the cranial MRI now?
Which is used only for things. Like who, it can be the subject or object of a
relative clause:
• The materials which are used for embolization are very expensive.
That is often used instead of who or which, especially in speech.
Whom is used only for people. It is grammatically correct as the object of
a relative clause, but it is very formal and is not often used in spoken English. We can use whom instead of who when who is the object of the relative clause or when there is a preposition after the verb of the relative
• The resident who I am going to the congress with is very nice.
• The resident with whom I am going to the congress is a very nice and
intelligent person.
• The patient who I saw in the Interventional Radiology Department yesterday has been diagnosed with Leriche’s syndrome.
• The patient whom I saw in the Interventional Radiology Department
yesterday has been diagnosed with Leriche’s syndrome.
Whose is the possessive relative pronoun. It can be used for people and
things. We cannot omit whose:
• Nurses whose wages are low should be paid more.
We can leave out who, which or that:
• When it is the object of a relative clause.
— The article on the spleen that you wrote is great.
— The article on splenic embolization you wrote is great.
• When there is a preposition. Remember that, in a relative clau5e, we
usually put a preposition in the same place as in the main clause (after
the verb):
— The congress that we are going to next week is very expensive.
— The congress we are going to next week is very expensive.
Unit II Radiological Grammar
Prepositions in Relative Clauses
We can use a preposition in a relative clause with who, which, or that, or
without a pronoun.
In relative clauses we put a preposition in the same place as in a main
clause (after the verb). We don’t usually put it before the relative pronoun.
This is the normal order in informal spoken English:
• This is a problem which we can do very little about.
• The nurse (who) I spoke to earlier isn’t here now.
In more formal or written English we can put a preposition at the beginning of a relative clause. But if we put a preposition at the beginning, we
can only use which or whom. We cannot use the pronouns that or who
after a preposition:
• This is a problem about which we can do very little.
• The nurse to whom I spoke earlier isn’t here now.
Relative Clauses Without a Pronoun (Special Cases)
Infinitive Introducing a Clause
We can use the infinitive instead of a relative pronoun and a verb after:
• The first, the second ... and the next
• The only
• Superlatives
For example:
• Roentgen was the first man to use X-rays.
• Joe was the only one to discover the diagnosis.
-Ing and -Ed forms Introducing a Clause
We can use an -ing form instead of a relative pronoun and an active verb:
• Residents wanting to train abroad should have a good level of English.
We can use an -ed form instead of a relative pronoun and a passive verb:
• The man injured in the accident was taken to the CT room.
The -ing form or the -ed form can replace a verb in a present or past
IIIIhy, IIIfhen and IIIfhere
We can use why, when and where in a defining relative clause.
We can leave out why or when. We can also leave out where, but then we
must use a preposition.
We can form non-defining relative clauses with when and where:
• The clinical history, where everything about a patient is written, is a
very important document.
We cannot leave out when and where from a non-defining clause.
An adjective describes (tells us something about) a noun.
In English, adjectives come before nouns (old hospital) and have the
same form in both the singular and the plural (new hospital, new hospitals) and in the masculine and in the feminine.
An adjective can be used with certain verbs such as be, get, seem, appear,
look (meaning seem), feel, sound, taste ... :
He has been ill since Friday, so he couldn’t report that bone age.
The patient was getting worse.
The ultrasound-guided core biopsy seemed easy, but it wasn’t.
The colonic luminogram appears black when it is normal.
You look rather tired. Have you tested your RBC?
She felt sick, so she stopped the renal transplant scan.
Food in hospitals tastes horrible.
As you can see, in these examples there is no noun after the adjective.
Adjective Order
We have fact adjectives and opinion adjeCtives. Fact adjectives (large, new,
white, ...) give us objective information about something (size, age, color,
...). Opinion adjectives (nice, beautiful, intelligent, ...) tell us what someone thinks of something.
In a sentence, opinion adjectives usually go before fact adjectives:
• An intelligent (opinion) young (fact) radiologist visited me this morning.
• Dr. Spencer has a nice (opinion) red (fact) Porsche.
Unit II Radiological Grammar
Sometimes there are two or more fact adjectives describing a noun, and
generally we put them in the following order:
1. Size/length
2. Shape/width
3. Age
4. Color
S. Nationality
6. Material
For example:
A tall young nurse
A small round lesion
A black latex leaded pair of gloves
A large new white latex leaded pair of gloves
An old American patient
A tall young Italian resident
A small square old blue iron monitor
Regular Comparison of Adjectives
The form used for a comparison depends upon the number of syllables in
the adjective.
/d)Rctives 0f One Syllable
One-syllable adjectives (for example fat, thin, fall) are used with expressions of the form:
• less ... than (inferiority)
• as ... as (equality)
• -er ... than (superiority)
For example:
• Calls are less hard than a few years ago.
• Eating in the hospital is as cheap as eating at the Medical School.
• Ultrasound examinations are difficult nowadays because people tend to
be fatter than in the past.
Adjectives of Two Syllables
Two-syllable adjectives (for example easy, dirty, clever) are used with expressions of the form:
• less ... than (inferiority)
• as ... a5 (equality)
• -erf more ... than (superiority)
We prefer -er for adjectives ending in (easy, funny, pretty ...) and other
adjectives (such as quiet, Simple, narroW, Clever ...). For other two-syllable
adjectives we use more.
For example:
The radiological problem is less Simple than you think.
My arm is as painful as it was yesterday.
The board exam was easier than we expected.
His illness was more serious than we first suspected, as demonstrated on
the high-resolution chest CT.
édJectives of Attlee of Note Syllables
Adjectives of three or more syllables (for example difficult, expensive, comfortable) are used with expressions of the form:
• less ... than (inferiority)
• as ... aS (equality)
• more ... than (superiority)
For example:
• Studying medicine in Spain is less expensive than in the States.
• The small hospital WaS OS COmfortable as a hotel.
• Studying the case was more interesting fhnn I had thought.
Before the comparative of adjectives you can use:
• a (little) bit
• a little
mn h
• a lot
• far
For example:
• I am going to try something much simpler to solve the problem.
• The patient is n little better today.
• The little boy is a bit worse today.
Sometimes it is possible to use two comparatives together (when we want
to say that something is changing continuously):
• It is becoming more and more difficult to find a job in an academic hospital.
We also say twiCe as ... OS, three times as ... as:
• Going to the European Congress of Radiology is twice as expensive as
going to the French one.
Unit II Radiological Grammar
The Superlative
The form used for a superlative depends upon the number of syllables in
the adjective:
/d)Rctives 0f One Syllable
One-syllable adjectives are used with expressions of the form:
• the ...-est
• the least
For example:
• The number of radiologists in your country is the highest in the world.
Adjectives of Two Syllables
Two-syllable adjectives are used with expressions of the form:
• tile ...-est/tLie most
• the least
For example:
• Barium enema is one of the commonest tests in clinical practice.
• Barium enema is one of the most common tests in clinical practice.
Adjectives 0f three 0t K0f8 Syllables
Adjectives of three or more syllables are used with:
• the most
• tile least
For example:
• Common sense and patience are the most important things for a radiologist.
• This is the least difficult brain CT I have reported in years.
Irregular Forms of Adjectives
• good better the best
• bad worse the worst
• far farther/further the farthest/furthest
For example:
• My ultrasound technique is worse now than during my first year of residence in spite of having attended several ultrasound refresher courses.
Unit II Radiological Grammar
Comparatives with The
We use the + comparative to talk about a change in one thing which causes
a change in something else:
• The nearer the X-ray focus the better image we have.
• The more you practice ultrasound the easier it gets.
• The higher the contrast amount the greater the risk of renal failure.
Two things happening at the same time or over the same period of time:
• The resident listened carefully as Dr. Fraser explained to the patient the
different diagnostic possibilities.
• I began to enjoy the residency more as I got used to being on call.
One thing happening during another:
• The patient died as the CT scan was being performed.
• I had to leave just as the differential diagnosis discussion was getting interesting.
Note that we use as only if two actions happen together. If one action follows another we don’t use as, we use the particle when:
• When the injured person came to the MRI room, I decided to call the
Meaning because:
• As I was feeling sick, I decided to go to the doctor.
Like and As
Like is a preposition, so it can be followed by a noun, pronoun or -ing
It means similar to or the same aS. We use it when we compare things:
• This comfortable head coil is like a velvet hat.
• What does he do? He is a radiologist, like me.
AS + subject + verb:
• Don’t change the dose of contrast agent. Leave everything as it is.
• He should have been treated a5 I showed you.
Meaning what:
• The resident did aS he was told.
• He made the diagnosis just with the chest X-ray, as I expected.
• As you know, we are sending an article to the European Journal of Radiology next week.
• As I thought, the patient was under the influence of alcohol.
As can also be a preposition, so it can be used with a noun, but it has a
different meaning from like.
As + noun is used to say what something really is or was (especially when
we talk about someone’s job or how we use something):
• Before becoming a radiologist I worked as a general practitioner in a
small village.
As if, as though are used to say how someone or something looks, sounds,
feels, ..., or to say how someone does something:
• The doctor treated me as if I were his son.
• John sounds as though he has got a cold.
Expressions with as:
• SuCh as
• As usual (Dr. Mas was late os usual.)
to and Such
So and such make the meaning of the adjective stronger.
We use so with an adjective without a noun or with an adverb:
• The first-year resident is so clever.
• The neuroradiologist injected lidocaine so carefully that the patient did
not notice it.
We use suCh With an adjective with a noun:
• She is such a clever resident.
Unit II Radiological Grammar
At/On/In time
We use at with times:
• At 7 o’clock
• At midnight
• At breakfast time
We usually leave out nf when we ask (of) what time:
• What time are you reporting this evening?
We also use af in these expressions:
At night
At the moment
At the same time
At the beginning of
At the end of
For example:
• I don’t like to be on call at night.
• Dr. Knight is reporting some studies at the moment.
We use in for longer periods of time:
• /n June
• in summer
• In 1977
\ Ve also say in the morning, in the afternoon, in the evening:
• I’ll report all the MRI studies in the morning.
We use on with days and dates:
On October 9th
On Monday
On Saturday mornings
On the weekend (At the weekend in British English)
We do not use af/in/or before last and next:
• I’ll be on call next Saturday.
• They bought a new scanner last year.
We use in before a period of time (i.e., a time in the future):
• Our resident went to Boston to do a rotation on abdominal imaging.
He’ll be back in a year.
/or, During and IIIfhiIe
We use for to say to how long something takes:
• I’ve worked as a radiologist at this hospital for ten years.
You cannot use during in this way:
• It rained for five days (not during five days).
We use during + noun to say when something happens (not how long):
• The resident fell asleep during the MR diffusion conference.
We use while + subject + verb:
• The resident fell asleep while he was attending the MR diffusion conference.
8y and Until
By + a time (i.e., not later than; you cannot use until with this meaning):
• I mailed the article on carotid dissection today, so they should receive it
by Tuesday.
Until can be used to say how long a situation continues:
• Let’s wait Befit the patient gets better.
When you are talking about the past, you can use fit the time:
• By the time they got to the hotel the congress had already started.
We use in as in the following examples:
In a room
In a building
in a town/in a country (Dr. Vida works in Cordoba.)
In the water/ocean/river
In a row
in the hospital
Unit II Radiological Grammar
We u5e nf as in the following examples:
At the bus stop
At the door/window
At the top/bottom
At the airport
At work
At sea
At an event (I saw Dr. Jules at the residents’ party.)
We use on as in the following examples:
• On the ceiling
• On the floor
• On the wall
• On a page
• On your nose
• On a farm
In Of’ EU
• \ Ve say in the corner of a room, but at the corner of a street.
• We say in or nf college/school. Use nf when you are thinking of the college/school as a place or when you give the name of the college/school:
— Thomas will be in college for three more years.
— He studied medicine at Harvard Medical School.
• With buildings, you can use tn or af.
• Arrive. We say:
— Arrive in a country or town (Dr. Vida arrived in Boston yesterday.)
— Arrive at other places (Dr. Vida arrived at the airport a few minutes
— But: arrive home (Dr. Vida arrived home late after sending the article
to AJR.)
Unit III Scientific Literature:
Writing an Article
This chapter is not intended to be a “Guide for Authors” such as those that
you can find in any journal. Our main advice is: do not write the paper
first in your own language and then translate it into English; instead, do it
in English directly.
Preliminary Work
When you have a subject that you want to report, first of all you need to
look up references. You can refer to the Index Medicus (http://
www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed) to search for articles.
Once you have found them, read them thoroughly and underline those sentences or paragraphs that you think you might quote in your article.
Our advice is not to write the paper in your own language and then
translate it into English; instead, write in English directly. In order to do
so, pick up, either out of these references, or out of the journal in which
you want your work to be published, the article that you find closest to the
type of study that you want to report.
Although you must follow the instructions of the journal to which you
want to send the paper, here we use a standard form that may be adequate
for most of them. In each section, we give you a few examples just to show
how you can get them from other articles.
Article Header
The title of the article should be concise but informative. Put a lot of
thought into the title of your article.
Unit III Scientific Literature: Writing an Article
An abstract of 150—250 words (it depends on the journal) must be submitted with each manuscript. Remember that an abstract is a synopsis, not
an introduction to the article.
The abstract should answer the question: “What should readers know
after reading this article.”
Most journals require that the abstract is divided into four paragraphs
with the following headings.
To state the purposes of the study or investigation; the hypothesis being
tested or the procedure being evaluated.
Notice that very often you may construct the sentence beginning with
an infinitive tense:
• To evaluate the impact of false-positive marks from computer-aided
detection (CAD) in 5creening mammography.
• To present our experience of AVM embolization.
• To study the diagnostic value of SPECT for multiple myeloma (MM).
• To assess bone marrow angiogenesis in patients with acute myeloid
leukemia (AML) by iron oxide-enhanced MRI.
• To compare the image acquisition time for digital versus film-screen
imaging for screening mammography in a hard copy interpretation
• To determine the prevalence of stenoses in dysfunctional autogenous
hemodialysis fistulas, patency following angioplasty and to identify
predictors of this patency.
• To develop an efficient and fully unsupervised method to quantitatively assess myocardial contraction from 4D-tagged MR sequences.
• To investigate the prognostic value of FDG PET uptake parameters in
patients who undergo an R0 resection for carcinoma of the lung.
• To ascertain recent trends in imaging workload among the various
medical specialties.
• To describe the clinical presentation, sonographic diagnosis and radiological treatment of uterine AVMs.
• TO assess the usefulness of three-dimensional (3D) gadolinium-enhanced MR urethrography and virtual MR urethroscopy in the evaluation of urethral pathologies.
• To establish ..., To perform ..., To study ..., To design ..., To analyze
..., To test ..., To define ..., To illustrate ...
Article Header
You can also begin with: “The aim/purpose/objective/goal of this study was
• The aim of this study was to determine the prognostic importance of
small hypoattenuating hepatic lesions on contrast-enhanced CT in patients with breast cancer.
• The purpose of this study was to compare feasibility and precision of
renal artery stent placement using two different MR guidance techniques.
• The objective of this study was to determine whether acute myocardial
infarction (MI) can be diagnosed on contrast-enhanced helical chest
You may give some background and then state what you have done.
• Autoimmune pancreatitis is a new clinical entity which frequently
mimics pancreatic carcinoma, resulting in unnecessary Radical surgery
of the pancreas. The purpose of this study was to describe radiologic
findiil S Of autoimmune panCreatitis.
• Myocardial fibrosis is known to occur in patients with hypertrophic
cardiomyopathy (HCM) and to be associated with myocardial dysfunCtion. ThiS St lf dy was designed to clarify the relation between myocardial fibrosis demonstrated by gadolinium-enhanced magnetic resonance
imaging (Gd-MRI) and procollagen peptides or cytokines.
. We hypothesized that ...
. We compared ...
. We investigated ...
Materials and Methods
Briefly state what was done and what materials were used, including the
number of subjects. Also include the methods used to assess the data and
to control bias.
N patients with ... were included.
N patients with ... were excluded.
N patients known to have/suspected of having ...
. was performed in N patients with ...
N patients underwent ...
Quantitative/Qualitative analyses were performed by ...
Unit III Scientific Literature: Writing an Article
• Patients were followed clinically for ... months/ years.
• We examined the effects of iodinated IV contrast on blood pressure,
heart rate and renal function after a CT 5COH iI1 14 healthy young volunteers.
Provide the findings of the study, including indicators of statistical significance. Include actual numbers, as well as percentages.
• 24 lesions were found. 15 (62.5%) were isointense, 4 (16.5%) hyperintense and 5 (21%) hypointense in the sequences acquired 90 minutes
after the administration of the liver-specific paramagnetiC CORtrast
agent. 13 lesions (54%) presented an enhaTlCing peripheral ring. All 6
patients OlSO Studied with 3D GE TI-weighted thinner slices (thickness
2.5 mm) had an enhancing peripheral ring (100 %).
• Hemidiaphragmatic elevation on plain radiographs and fluoro5COpiC
paradoxical movement of the diaphragm after transarterial chemoembolization (TACE) via the inferior phrenic artery (IPA) were observed
in 6/15 patients (40%) and 7/15 patients (46.7%), reSpeCtively. Vitol COpacit y decreased from the pre-TACE measurements (% of predictive
value) of 88.80+19.95 to 82.60+19.33 after TAC£ (p——0.05). No significant Correlation was noted between the dosage of chemoembolic agents
and the presence or absence of paradoxical diaphragmatic movement
or vital capacit y lung.
• Twelve patients had aCute myocardial infaTCtlOil (AMI) and nine patients acute myocarditis (AM). All AMI but one displayed a territorial
early subendocardial defect with corresponding delayed enhancement.
All AMI displayed stenosis Of at least the corresponding coronary artery. All AM but one displayed normal first-pass enhancement patterns
and focal or diffuse nonterritorial nonsubendocardial delayed enhancement with normal COronary arteries in all cases.
Summarize in one or two sentences the conclusion(s) made on the basis of
the findings. It should emphasize new and important aspects of the study
or observations.
Main Text
• Multi-detector row CT IS an effective tool for depicting orthopedic
hardware complications.
• Contrast enhanCement characteriStic5 Of breast cancer are significantly
affected by contrast injection rate. It IS Critical to incorporate contrast
injection rate into pharmacokinetic modeling for accurate characterization of breast cancer.
• ControSt-enhanced color Doppler imaging demonstrated an overall accuracy of 100% for the detection of crossing vessels at the obstructed
UPJ. This technique Showed Comparable results to CT and MRI and
therefore provides accurate information for the detection of vessels
crossing at the obstructed UPJ.
• US is moderately aCCtlrate in the diagnosis of substantial fatty atrophy
of the supraspinatus or infraspinatus muscles.
• The Study data demonstrate ..., Preliminary findings indicate ..., Results suggest ...
Below the abstract you should provide, and identify as such, three to ten
keywords or short phrases that will assist indexers in cross-indexing the
article and may be published with the abstract. The terms used should be
from the Medical Subject Headings list of the Index Medicus (http://
Main Text
The text of observational and experimental articles is usually (but not necessarily) divided into sections with the headings Introduction, Methods, Result5, and Discussion. Long articles may need subheadings within some sections (especially the Results and Discussion sections) to clarify their content. Other types of articles, such as Case Reports, Reviews, and Editorials,
are likely to need other formats. You should consult individual journals for
further guidance.
Avoid using abbreviations. When used, abbreviations should be spelled
out the first time a term is given in the text, for example magnetic resonanCe imagiR (MRI).
Unit III Scientific Literature: Writing an Article
The text should begin with an Introduction that conveys the nature and
purpose of the work, and quotes the relevant literature. Give only strictly
pertinent background information necessary for understanding why the
topic is important and references that inform the reader as to why you undertook your study. Do not review the literature extensively. The final paragraph should clearly state the hypothesis or purpose of your study. Brevity
and focus are important.
Materials and Methods
Details of clinical and technical procedures should follow the Introduction.
Describe your selection of the observational or experimental subjects (patients or laboratory animals, including controls) clearly. Identify the age, sex,
and other important characteristics of the subjects. Because the relevance of
such variables as age, sex, and ethnicity to the object of research is not always
clear, authors should explicitly justify them when they are included in a study
report. The guiding principle should be clarity about how and why a study
was done in a particular way. For example, authors should explain why only
subjects of certain ages were included or why women were excluded. You
should avoid terms such as “race”, which lack precise biological meaning,
and use alternative concepts such as “ethnicity” or “ethnic group” instead.
You should also specify carefully what the descriptors mean, and say exactly
how the data were collected (for example, what terms were used in survey
forms, whether the data were self-reported or assigned by others, etc.).
Our study population was selected from ...
N patients underwent ...
N consecutive patients ...
N patients with proven ...
PatientS were followed clinically ...
N patients with ... were examined before and during ...
N patients with known or suspected ... were prospectively enrolled in
this 5tudy.
• More than N patients presenting with ... were examined with ... over
a period of N months.
• N patients were prospectively enrolled between ... (date) and ... (date).
• N patients (N men, N women; age range N—N years; mean N.N years).
• In total, 140 patients, aged 30-50 years (mean 40 years), all with
severe acute pancreatitis fulfilling RamsOn Criteria, were included in
the Study.
• Patients undergoing eleCtive coronary arteriography for evaluation of
chest pain were considered eligible if angiography documented ...
Main Text
Identify the methods, instrumentation (trade names and manufacturer’s
name and location in parentheses), and procedures in sufficient detail to
allow other workers to reproduce your study. Identify precisely all drugs
and chemicals used, including generic name(s), dose(s), and route(s) of administration.
• MR imaging was performed with a 1.5-T system (Vision; Siemens, £rlangen, Germany).
• The US-guided biops y procedures were performed using model RT 3000
equipment (GE Medical Systems, Milwaukee, Wis.) with either a 3.5- or
a 5-MHz sector transduCer combined with a needle guide or a 5-MHz
linear-array traHSducer with a free-hand technique.
• Automatic high-speed core biopsy equipment (Biopt y instrument and
Biopt y-Cut needles; Bard UrologiCal, Cov ington, Ga.) was used.
• After baseline P£T investigation, 40 mg of fluvastatin (Cranoc, Astra)
was administered once daily.
• DynamlC PET measurements were performed with a whole-bod y SCanner (CTI/ECAT 951R/31; Siemens/CTI). After a trOHSmission scan for
attenuation correction, 20 mCi of ” N-labeled ammonia was administered as a bolus over 30 SeConds by an infusion pump. The dynamlC
PET data acquisition consisted of varying frame duratiOHS (12 x 10 Seconds, 6 z 30 seconds, and 3 X 300 seConds). For the stress study, adenosine was infused at a dose of 0.14 m-g kg - min 1 over S minutes. 1’ Nlabeled ammonia was administered in a similar fashion aS in the baseline study during the third minute of the adenosine infusion.
It is essential that you state the manner by which studies were evaluated:
independent readings, consensus readings, blinded or unblinded to other
information, time sequencing between readings of several studies of the
same patient or animal to eliminate recall bias, random ordering of studies.
It should be clear as to the retrospective or prospective nature of your
Entry/inclusion criteria included ...
These criteria had to be met: ...
Patients with ... were not included.
Further investigations, including ... and ..., were also performed.
We prospectively studied N patients W lth ...
The reviews were not blinded to the presenCe of ...
The following patient iTlCltiSiOn Criteria were used: age between 16 and
S0 years and closed epiphyses, ACL injury of one knee that required
surgical replacement with a bone-to-patellar tendon-to-bone autograft,
and signed informed consent with agreement to attend follow-up visits.
The following exclusion Criteria were used: additional ligament laxities
Unit III Scientific Literature: Writing an Article
with a grade higher than 2 (according to the European classification of
frontal laxity) in the affected knee, ...
• TWo Skeletal Radiologists (O.J., C.V.) in ConSensus studied the following
parameters on Successive MR images ...
• Both the interventional cardiologists and echocardiographers who performed the study and evaluated the results were blinded to drug administration.
• Histologic samples were evaluated in a blinded manner by one of the
authors and an outside expert in rodent liver pathology.
Give references to established methods, including statistical methods that
have been published but are not well known; describe new or substantially
modified methods and give reasons for using these techniques, and evaluate their limitations. Identify precisely all drug5 and chemicals used, including generic name(s), dose(s), and route(s) of administration. Do no
use a drug’s trade name unless it is directly relevant.
• The imaging protocol included ...
• To assess objectively the severit y of aCute panCreatitis, all patients were
scored using the Balthazar criteria (10).
• The Stereotactic device used for breast biopsy has been described elSewhere (12); it consists of a ...
• Gut permeabilit y was measured in isolated intestinal segments as described previously (2).
Describe statistical methods with enough detail to enable a knowledgeable
reader with access to the original data to verify the reported results. Put a
general description of methods in the Methods section. When data are
summarized in the Results section, specify the statistical methods used to
analyze them:
• The statistical signifiCance of differenCes was calculated with Fisher’s
exact test.
• The probabilit y of ... was calculated using the Kaplan-Meier method.
• To test fOY Stotistical significance, ...
• Statistical analyses were performed with ... and ... tests.
• The levels of Significance are indicated by P ValueS.
• Interobserver agreement was quantified by using k statistics.
• All P ¥alueS of less than 0.05 were ConSidered to indicate statistiCal significance.
Main Text
• Univariate and multivariate Cox proportional hazards regression mOdels were used.
• The v’-test was used for group comparison. Descriptive values of variables are expressed as means and percentages.
• We adjusted RRs for age (5-year categories) and used the Mantel extension test to test for linear trends. To adjust for other risk factors, we
used multiple logistic regresSiOH.
Give details about randomization:
• They were selected consecutively by one physician between February
1999 and June 2000.
• This study was conducted prospectively during a period of 30 months
from MaFC 1998 to August 2000. We enrolled 29 consecutive patients
who had ...
Specify any general-use computer programs used:
• All statistical analyses were performed with SAS software (SAS Institute, Cary, N.C.).
• The statistical analyses were performed using a software package (SPSS
for Windows, release 8.0; SPSS, Chicago, Ill.).
Present your results in logical sequence in the text, along with tables, and
illustrations. Do not repeat in the text all the data in the tables or illustrations; emphasize or summarize only important observations. Avoid nontechnical uses of technical terms in statistics, such as “random” (which implies a randomizing device), “normal 3’, “significant”, “correlations’ 3 , and
“sample”. Define statistical terms, abbreviations, and most symbols:
StatlStically significant differences were shown for both X and X.
Significant correlation Was found between X and X.
ReSultS are expressed as means k SD.
All the abnormalities in our patient population were identified on the
prospective clinical interpretation.
• The abnormalities were correctly characterized in 14 patients and incorrectly in ...
• The preoperative and operative Characteristics of these patients are
listed in Table 1.
Unit III Scientific Literature: Writing an Article
• The results of the US-guided core-needle pleural biOpsieS are shown in
Table 1.
• The clinical findings are summarized in Table 1.
Report any complication:
• Two minor complications were encountered. After the second procedure,
one patient had a slight hemoptysis that did not require treatment,
and one patient had IOCOI Chest pain for about 1 hour after a punCture
in the supraclavicular region. Pneumothorax was never encountered.
• Among the 11,101 patients, there were 575 in-hospital deaths (3.4%),
204 intraoperative/postoperative CVAS (1.8%), 353 patients With postoperative bleeding events (3.2%), and 142 patients Wlth Sternal wound
infections (1.3%).
Give numbers of observations. Report losses to observation (such as dropouts from a clinical trial):
• The final study cohort consisted of ...
• Of the 961 patients included in this study, 69 were reported to have
died (inCluding 3 deaths identified through the NDI), and 789 patients
were interviewed (Figure 1). for 81 StITv iving patients, information
was obtained from another source. Twent y-two patients (2.3%) could
not be ContaCted and were not included in the analyses because infor-
mation on nonfatal events Was not available.
Within this section, use ample subheadings. Emphasize the new and important aspect5 Of the study and the conclusions that follow from them. Do
not repeat in detail data or other material given in the Introduction or the
Results sections. Include in the Discussion section the implications of the
findings and their limitations, including implications for future research.
Relate the observations to other relevant studies.
Link the conclusions with the goals of the study, but avoid unqualified
statements and conclusions not completely supported by the data. In particular, avoid making statements on economic benefits and costs unless the
report includes economic data and analyses. Avoid claiming priority and
alluding to work that has not been completed. State new hypotheses when
warranted, but clearly label them as such. Recommendations, when appropriate, may be included.
In conclusion, ...
In summary, ...
This study demonstrates that ...
ThlS Stlf dy found that ...
This study highlights ...
Another finding of our study is ...
One limitation of our study was ...
Other methodological limitations of this study ...
Our results 5upport ...
Further research is needed to elucidate ...
However, the limited case number warrants a more comprehensive
studf' tO COilfirm these findings and tO assess the comparative predictive value of relative lung volume versus LHR.
• Some follow-up IS probably appropriate for these patients.
• Further research is needed when endoluminal surfaCe coil technolog y is
List all contributors who do not meet the criteria for authorship, such as a
person who provided purely technical help, writing assistance, or a department chair who provided only general support. Financial and material support should also be acknowledged.
People who have contributed materially to the paper but whose contributions do not justify authorship may be listed under a heading such as
“clinical investigators” or “participating investigators and their function
or contribution should be described: for example, “served as scientific advisors,” “critically reviewed the study proposals “collected data,” or “provided and cared for study patients.”
Because readers may infer their endorsement of the data and conclusions, everybody must have given written permission to be acknowledged.
• The authors express their gratitude to ... for their excellent technical
• The authors thank Wei J. Chen, MD, ScD, Institute of £pidemiolog y,
College of Public Health, National Taiwan UniverSit y, Taipei, for the
analysis Of the statistiCS and his help in the evaluation of the data.
The authors also thank Pan C. Yang, MD, PhD, Department of Internal
Medicine, and Keh S. Tsar, MD, PhD, Department of Laboratory Medicine, National Taiwan UniverSit y, Medical College and HOSpital, Taipei,
for the inspiration and discussion of the research idea of this study. We
also thank Ling C. Shen for her as5iStance in preparing the manu5CFlpt.
Unit III Scientific Literature: Writing an Article
References should be numbered consecutively in the order in which they
are first mentioned in the text. Identify references in text, tables, and legends by Arabic numerals in parentheses (some journals require superscript
Arabic numbers). References cited only in tables or figure legends should
be numbered in accordance with the sequence established by the first citation in the text of the particular table or figure.
• Clinically, resting thallium-201 (2’ 1Tl) Single photon emission computed tomography (SPECT) has been widely used to evaluate myocardial viability in patients with chronic coronary arterial disease and
acute myocardial infarction (8—16).
• In addition, we have documented a number of other parameters previously shown to exhibit diurnal variation, including an assessment of
sympathetic activity, aS well as inflammatory markers recently shown
to relate to endothelial function.”
Use the style of the examples below, which are based on the formats used
by the NLM in Index Medicus. The titles of journals should be abbreviated
according to the style used in Index MedicuS. Consult the List of Journals
Indexed in Index Medicus, published annually as a separate publication by
the library and as a list in the January issue of Inder Medicus. The list can
also be obtained through the library’s website (http://www.nlm.nih.gov).
Avoid using abstracts as references. References to papers accepted but
not yet published should be designated as “in press” or “forthcoming”;
authors should obtain written permission to cite such papers as well as verification that they have been accepted for publication. Information from articles submitted but not accepted should be cited in the text as “unpublished observations” with written permission from the source.
Avoid citing a “personal communication” unless it provides essential information not available from a public source, in which case the name of
the person and date of communication should be cited in parentheses in
the text. For scientific articles, authors should obtain written permission
and confirmation of accuracy from the source of a personal communication.
The references must be verified by the author(s) against the original
The Uniform Requirements style (the Vancouver style) is based largely
on an ANSI standard style adapted by the NLM for its databases. Notes
have been added where Vancouver style differs from the style now used by
Articles in Journals
Standard Journal Article
List the first six authors followed by et al. (Note: NLM now lists up through
25 authors; if there are more than 25 authors, NLM lists the first 24, then
the last author, then et al.)
Theodorou S J, Theodorou DJ, Schweitzer ME, Kakitsubata Y, ReSniCk D.
Magnetic resonanCe imaging of para-acetabular insufficienc y fractures in
patients with malignanc y. Clin Radiol 2006 Feb, 61(2):181-190.
As an option, if a journal carries continuous pagination throughout a volume (as many medical journals do) the month and issue number may be
omitted. (Note: for consistency, the option is used throughout the examples
in Uniform Requirements. NLM does not use the option.)
Theodorou S J, Theodorou DJ, Schweitzer ME, Kakitsubata Y, ResniCk D.
MagnetiC resonance imaging of para-aCetabular iH5tlfficienc y fraCtures in
patients with malignanc y. Clin Radiol 2006; 61:181-190.
Organization as Author
The Evidence-based Radiology Working Group. Ev idence-based radiology:
a new approach to the practice of radiology. Radiology 2001; 220:566—57S.
/¥o dvthor Given
Cancer in South Africa [editorial]. S Afr Med J 1994; 84:15.
Article Not In English
(Note: NLM translates the title to English, encloses the translation in
square brackets, and adds an abbreviated language designator.)
Zangos S, Mack MG, Straub R, et al. [Transarterial chemoembolization
(TACE) of liver metastases: a palliative therapeutic approach]. Radiologie
2001:4J (1):84—90. German
Unit III Scientific Literature: Writing an Article
I/’o/vme with Supplement
Shen HM, Zhang QA. Risk assessment of nickel carcinogenicity and occupational lung CanCer. Environ Health Perspect 1994; 102 Suppl 1:275-282.
Issue with Supplement
Payne DK, Sullivan MD, Massie M J. Women’s psychOlogiCal reactions to
breast cancer. Semin Oncol 1996; 23(1 Suppl 2):89-97.
Hamm B, StakS T, Taupitz M. SHU 555A: a new superparamagnetic iron
oxide contrast agent for magnetic resonance imaging. Invest Radiol 1994;
29(Suppl 2):587-589.
I/’o/vme with Part
Ozben T, Nacitarhan S, Tuncer N. PlOSTna and urine sialic acid in noninsulin dependent diabetes mellitus. Ann Clin BioChem 1995; 32(Pt 3): 303—
Issue with Part
Poole GH, Mills SM. One hundred consecutive CaseS of flap lacerations of
the leg in ageing patients. N Z Med J 1994; 107(986 Pt 1):377—378.
Issue with /¥o Volume
Turan I, Wredmark T, Fellander-Tsar L. Arthroscopic ankle arthrodesis in
rheumatoid arthTltlS. Clin Orthop 1995; (320):110—114.
/¥o Issue or Volume
Browell DA, Lennard 'rW ITt›munolOgiC 5tatus of the Cancer patient add
the effects Of blood transfusion on antitumor responses. Curr Opin Gen
Surg 1993:325-333.
Pages in ftoman Numerals
Fisher GA, Sikic BI. Drug resistance in clinical oncology and hematology.
IntroduCtlon. Hematol Oncol Clin North Am 199s Apr; 9(2):xi—xii.
Type of Article Indicated as feeded
Enzensberger W, Fischer PA. Metronome in Parkinson’s disease [letter].
Lancet 1996; 547:1337.
Clement J, De Bock R. Hematological complications of hantavirus nephropathy (HVN) [abstract]. Kidney Int 1992; 42:1285.
Article Containing ftefraction
Garey CE, Schwarzman AL, Rise ML, Seyfried TN. Ceruloplasmin gene
defect associated with epilepsy in EL mice [retraction of tsarey CE,
Schwarzman AL, RiSe ML, Seyfried TN. In: Nat Genet 1994; 6:426-431 J.
Nat tsenet 1995; 11:104.
Article Retracted
Liou GI, Wang M, Matragoon S. Precocious IRBP gene expression during
mouse development [retracted in Invest Ophthalmol Vis Sci 1994;
35:3127]. Invest Ophthalmol Vis Sci 1994; 3S:1083-8.
Article with Published Erratum
Hamlin JA, Kahn AM. Herniography in S ymptomatic patients following
inguinal hernia repair [published erratum appears in West J Med 1995;
162:278]. West J Med 1995; 162:28-31.
Books and Other Monographs
Personal dvt/ior/sJ
Helms CA. Fundamentals of skeletal radiology. 1st ed. Philadelphia: WB
Saunders Company; 1992.
(Note: Previous Vancouver style incorrectly had a comma rather than a
semicolon between the publisher and the date.)
Unit III Scientific Literature: Writing an Article
yditor(s), Compiler(s) as dtithor
Rumack CM, Wilson SR, Charboneau JW, editors. Diagnostic ultrasound.
St Louis: MoSby- Year Book; 1998.
Organization as Author and Publisher
Institute of Medicine (US). Looking at the future of the Medicaid program. Washington: The InStitute; 1992.
Chapter in a Book
Levine MS. Benign tumors of the esophagus. In: Gore RM, Levine MS,
editors. Textbook of gastrointestinal radiology. 2nd ed. Philadelphia, Pa:
Saunders; 2000. Up. s87—402.
(Note: Previous Vancouver style had a colon rather than a p before pagination.)
Conference Proceedings
Kimura J, Shibasaki H, editors. Recent advances in clinical neurophySlOlogy. Proceedings of the 10th International Congress of EMG and Clinical
NeurophySiology; 1995 Oct 15—19; Kyoto, Japan. Amsterdam: Elsevier;
Conference Paper
Bengtsson S, Solheim BG. Enforcement of data protection, privac y and
securit y in medical informatics. In: Lun KC, Degoulet P, Piemme TE,
Rienhoff 0, editors. M£DINFO 92. Proceedings of the 7th World Congress
on Medical Informatics; 1992 Sep 6—10; Geneva, Switzerland. Amsterdam:
North-Holland; 1992. pp. 1561-1565.
Scientific or Technical /teport
Issued by funding/sponsoring agency:
Smith P, Golladay K. Payment for durable medical equipment billed
during skilled nursing facilit y stays. Final report. Dallas (TX): Dept. of
Health and Human Services (US), Office of Evaluation and InspectiOHS;
1994 Oct. Report No.: HHSIGOEI69200860.
Issued by performing agency:
Field M J, Tranquado RE, FeaSle y JC, editors. Health services research:
work force and educational issues. WaShington: National Academy PresS;
1995. COTItTOCt No.: AHCPR282942008. Sponsored by the AgenC y for
Health Care Polic y and Research.
Kaplan S J. Post-hospital home health care: the elderly’s access and utilization [dissertation]. St. Louis (MO): Washington Univ.; 1995.
Larsen CE, Trip R, Johnson CR, inventors; Novoste Corporation, assignee.
Methods for procedures related to the electrophysiology of the heart. US
patent S,529,067. 1995 Jun 25.
Other Published Material
Newspaper Article
Lee G. Hospitalizations tied to ozone pollution: Study estimates 50,000 admissions annually. The WashingtOn POSt 1996 Jun 21; Sect. A:3 (col. 5).
Audiovisual Material
HIV+/AIDS: the facts and the future [videocassette]. St. Louis (MO): Mosby Year-Book; 1995.
Unit III Scientific Literature: Writing an Article
Dictionary and Similar /teferences
Stedman’s medical dictionary. 26th ed. Baltimore: Williams H Wilkins;
1995. Apraxia; pp. 119—120.
Unpublished Material
In Press
(Note: NLM prefers “forthcoming” because not all items will be printed.)
Assessment of chest pain in the emergenC y room: What is the role of multidetector CT? Our J Radiol. In press 2006.
Electronic Material
Journal Article in Electronic format
Morse SS. Factors in the emergence of infectious diseases. £merg Infect
Dis [serial online] 1995 Jan-Mar [cited 1996 Jun 5]; 1(1):{24 screens].
Available from: URL: http://www.cdc.gov/ncidod/EID/eid.htm.
Monograph in Electronic format
CDI, CllillCal dermatology illustrated [monograph on CD-ROM]. Reeves
JRT, Maibach H. CMEA Multimedia Group, producers. 2nd ed. VerSiOI1
2.0. San Diego: CMEA; 1995.
Offiprter file
Hemodynamics III: the ups and downs of hemodynaiTllCS [computer program]. Version 2.2. Orlando (ML): Computerized Educational Systems;
Additional Material
All tabulated data identified as tables should be given a table number and
a descriptive caption. Take care that each table is cited in numerical sequence in the text.
The presentation of data and information given in the table headings
should not duplicate information already given in the text. Explain in footnotes all non-standard abbreviations used in the table.
If you need to use any table or figure from another journal, make sure
you ask for permission and put a note such as:
Adapted, with permission, from referenCe 5.
Figures should be numbered consecutively in the order in which they are
first cited in the text. Follow the “pattern” of similar illustrations of your
• Figure 1. Non-enhanced CT scan shows ...
• Figure 2. Contrast-enhanced CT scan obtained at the level of...
• Figure 3. Selective renal arteriogram SLiows ...
• Figure 4. Photograph of a fresh-Cut SpeCimen ShOws ...
• higure 5. Photomicrograph (original magnification, x 10; hematoxylineosin stain) of...
• Figure 6. Coronal contrast-enhanced Tl-weighted MR image of...
• Figure 7. Typical metastatiC COmpreSsiOn fFOCture in a 65-year-old
man. (a) Sagittal Tl-weighted MR image (400/11) shows ...
Unit III Scientific Literature: Writing an Article
• Figure 6. NaSal-t ype extraTlOdal NK/T-cell lymphoma involving the nasal cavity in a 42-year-old woman. Photomicrograph (original magnification, x 400; hematox ylin-eosin [H-E] stain) of a na5al iTIHCOSOl lOpS f'
specimen Shows intense infiltration of atypical lymphoid cells into the
vascular intima and subintima (arrows. This is a typiCal appearanCe of
angiocentriC invasion in whiCh the vascular lumen (VJ is nearly obstructed.
• Figure 7. AUX with distortion of hiStOpathologic architecture aS a consequence of intratumoral ...
• Figure 8. CT images obtained in a 75-year-old man with gross hematuria. (a) MIP image obtained during the compression-release excretory
phase demonstrates a non-obstructing Calculus (arrows in the distal
portion of the right ureter.
Final Tips
Before you submit your article for publication check its spelling, and go
over your article for words you might have omitted or typed twice, as well
as words you may have misused such as using “there” instead of “their.”
Do not send an article with spelling or dosage errors or other medical inaccuracies. And do not expect the spell-check function on your computer
to catch all your spelling mistakes.
Be accurate. Check and double-check your facts and reference citations.
Even after you feel the article is finished leave it for a day or two and then
go back to it. The changes you make to your article after seeing it in a new
light will often be the difference between a good article and a great article.
Once you believe everything is correct, give the draft to your English
teacher for a final informal editing. Do not send your first (or even second) draft to the publisher!
Do not forget to read and follow carefully the specific “Instructions for
authors” of the journal in which you want your work to be published.
���� ��
Unit IV Letters to Editors
of Radiological Journals
This unit is made up of several examples of letters sent to editors of radiological journals. Our intention is to provide you with useful tools to communicate with journal editors and reviewers in a formal manner. It is our
understanding that letters to editors have quite an important, and many
times overlooked, role in the fate of scientific radiological manuscripts.
Although we are not going to focus on letters from editors since they
are, generally speaking, easy to understand, these letters can be divided
into acceptance “under certain conditions” letters, acceptance letters, and
rejection letters.
• Acceptance “under certain conditions” letters. These letters, are relatively
common, and usually mean a great deal of work since the paper must
be re-written.
• Acceptance letters. Congratulations! Your paper has finally been accepted
and no corrections have to be made. These letters are, unfortunately, relatively uncommon, and quite easy to read. Besides, they do not need to
be replied to.
• Rejection letters. There are many polite formulas of letting you know
that your paper is not going to be published in a particular journal.
These letters are instantly understood and since they do not need to be
replied to, no time needs to be wasted on them from an idiomatic point
of view.
We have divided up the letters to editors into:
Submission letters
Re-submission letters
Re-configuration letters
Letters of thanks for an invitation to publish an article in a journal
Letters asking about the status of a paper
Other letters
Unit IV Letters to Editors of Radiological Journals
Submission Letters
Submission letters are quite easy to write since the only message to be conveyed is the type and title of the paper you are submitting and the name
of the corresponding author. Many standard letters can be used for this
purpose and we do not think you have to waste too much time on them
since they are mere preliminary material that just needs to be sent along
with the paper itself.
Your address
Receiver’s name and address
Dear Dr. Massa,
Please find enclosed (N) copies of our manuscript entitled “...” (authors
, ..., ...), which we hereby submit for publication in the ... Journal of
. Also enclosed is a diskette with a copy of the text file in Microsoft
Word for Windows (version ...).
I look forward to hearing from you.
Yours sincerely,
A. J. Merckel, MD
Re-submission Letters
Re-submission Letters
Re-submission letters must thoroughly address the comments and suggestions of acceptance letters. It is in these letters where the corresponding
author must let the editor know that all or at least most of the suggested
changes have been made and, in doing so, the paper could be ready for
publication. These letters may play quite an important role in the acceptance or rejection of a paper. Sometimes a lack of fluency in English prevents the corresponding author conveying the corrections made in the
manuscript and the reasons why other suggested changes were not made.
Let’s review the following example:
Dear Dr. Ho,
After a thorough revision in light of the reviewers’ comments, we have
decided to submit our paper “MRI evaluation of extrahepatic cholangiocarcinoma” for re-evaluation.
First of all, we would like to thank you for this second chance to present
our paper for publication in your journal.
The main changes in the paper are related to your major comments:
— to improve overall image quality (including some new cases).
— to indicate what the clinical role of MRI is.
— to present our imaging diagnostic algorithm in cases of extrahepatic
cholangiocarcinoma (new Tables 2 and 3).
Following your advice, we have also included changes that are in accordance with the reviewers’ comments.
We hope this new version will now be suitable for publication in your journal.
Yours sincerely,
Antonio Belafonte, MD, and co-authors
Unit IV Letters to Editors of Radiological Journals
Re-configuration Letters
Sometimes the paper is accepted provided its configuration is changed, i.e.,
from a pictorial review to a pictorial essay. Re-configuration letters are resubmission letters as well and, therefore, tend to be long.
Review this example from which we have extracted and underlined several sentences that can help you in your correspondence with journals.
“Magnetic Resonance Evaluation of focal splenic lesions” RE:01-1343
Dear Dr. Woods, (1)
We have re-configured the manuscript referenced above (2) in the form of a
Pictorial Essay following your suggestion (3) and we have made as many
changes as possible with regard to the reviewers’ recommendations taking
into account the space limitation imposed by the new format of the paper (4).
We have tried to cover all entities involving spleen focusing on their more
characteristic imaging features and giving priority to the most prevalent
conditions (5). The re-configuration of the manuscript has shortened it so
drastically that we have had to rewrite it entirely and for this reason we do
not attoCh an nnnoinled copy (6) — if you still consider this necessary we
will include it (7). Although tables are not permitted in Pictorial Essays, we
think that the inclusion of a single table on the classification of focal splenic lesions would “allow the reader to more easily categorize the described
imaging findings”(8) as stated by reviewer no. 2 (9) in his general remarks.
The table has not been included due to the new format of the paper but if
you take our suggestion into consideration we will be pleased to add it (10).
The major changes in our manuscript are:
1. The title has been modified to “Dynamic-enhanced MR imaging of focal
splenic lesions” following your recommendation (11).
2. We have included the technical parameters of our imaging protocol
although it has not been possible to expand the technical section as suggested by reviewer no. 1 (12) due to space limitation.
3. Similarly, the description of infectious lesions and lymphoma could not
be expanded as suggested by reviewer no. 2 due to SpaCe limitatlOll (13).
4. With regard to figures (14):
a. We have included six new figures.
b. More sequences on a given lesion have been included (lS), as suggested, in figures 4, 7, 12, and 14.
c. The image quality of figure 5 has been improved (16).
Re-configuration Letters
5. We have assigned distinct figures to different entities in most cases
although the limited number of figures allowed — 15 — made it impossible to do it in all cases.
6. With regard tO comments 011 figures by reviewer no. 1 (17):
- Figure 4e is indeed an immediate phase postcontrast image (18). Aortic enhancement is not well seen due to the poor contrast resolution
of this image which was acquired a long time ago and was one of our
first abdominal MR 3D acquisitions.
— Figure 6b shows a ghOStlng aY tlfact due to poor breath-holding (19).
7. SPIO section has been erased (20) due, again, to space limitation.
We look forward to hearing from you, (21)
Your5 Sincerely, (22)
John Best, MD, and co-authors (23)
I. Dear Dr. Woods,
— This sentence ends with a comma rather than a semicolon.
2. We have reconfigured the manuscript referenCed above
— The content of the letter must be summarized in the first paragraph.
3. ... following your suggestion
— This is one of the commonest sentences in re-submission/re-configuration letters.
4. ... space limitation imposed by the new format of the paper
— Space limitation, provided the new format limits it, must be taken
into consideration by both the authors and the reviewers.
5. ... giving priorit y to the most prevalent conditions
— May be a criterion for the shortening of the manuscript.
6. ... for this reason we do not attach an annotated copy
— Whenever you don’t follow a suggestion, you must give an explanation.
7. ... if you still consider it neCessary we will illClude it
— Always leave open the possibility of adding more information in
further correspondence.
8. ... “allow the reader to more easily categorize the described imaging
— You can use as an argument what was literally suggested by the reviewer by writing it in inverted commas.
9. ... as stated by reviewer no. 2
— This is a usual way of addressing a reviewer’s comment.
Unit IV Letters to Editors of Radiological Journals
. if you take our suggestion into consideration we will be pleased to
add it
— This sentence can be used whenever you want to include something
which has not been requested by the reviewers.
The title has been modified to ... following your recommendation.
— This is a usual way of addressing a reviewer’s comment.
We have included the technical parameters of our imaging protocol as
suggested by reviewer no. 1
— This is a usual way of addressing a reviewer’s comment.
Similarly, ... could not be expanded as suggested by reviewer no. 2 due
tO Space limitation
— Whenever you don’t follow a suggestion, you must give an explanation.
With regard to figures:
— Or regarding figures, as regards figures, as for figures (without the
preposition “to”).
More sequences on a given lesion have been included
— This is a usual way of addressing a reviewer’s comment.
The image quality of figure S has been improved
— This is a usual way of addressing a reviewer’s comment.
With regard to comments on figures by reviewer no. 1:
— This is a usual way of addressing a reviewer’s comment.
Figure 4e iS indeed an immediate phase postCOlltrast image
— This is a usual way of addressing a reviewer’s comment.
Figure 6b ShOws a ghosting artifact due to poor breath-holding
— This is a usual way of addressing a reviewer’s comment.
SPIO section has been erased due, again, to space limitation
— This is a usual way of addressing a reviewer’s comment.
We look forward to hearing from you,
— Remember that the verb following the verb “to look forward to”
must be in its -ing form.
Yours sincerely,
— Bear in mind that if you don’t know the name of the editor you
should write “Yours faithfully” instead.
John BeSt, MD, and co-authors
— Although the corresponding author is the only one who signs the
letter, sometimes a reference is made to the co-authors.
Letters of Thanks for an Invitation to Publish an Article in a Journal
Letters of Thanks for an Invitation to Publish
an Article in a Journal
These are simple and usually short letters in which we let the editor of a
journal know how pleased we are regarding his/her invitation and how
much we appreciate his/her consideration.
Your address
Receiver’s name and address
Dear Dr. Massa,
Thank you for the invitation to submit a manuscript on focal hepatic lesions to your journal.
Please find attached our paper which details our imaging protocol and
makes a thorough revision of the literature on the subject.
I look forward to hearing from you.
Yours sincerely,
A. J. Cantona, MD
Unit IV Letters to Editors of Radiological Journals
Asking About the Status of a Paper
In these letters we inquire about the situation of our article since we have
not received any response from the journal. Regrettably in the academic
world “no news” is not usually “good news”, and many of these inquiries
end up with a polite rejection letter.
Dear Dr. Ross,
As I have not received any response regarding the manuscript “MRCP of
cholangiocarcinoma”, I am interested in obtaining some information on
the status of the paper.
Please, use the following e-mail address for further correspondence:
I look forward to hearing from you at your earliest convenience,
J. Sanz, MD, PhD
Other Letters
Applying for a Post
11 St Albans Road
London SW17 5TZ
17 November 2006
The Medical Staffing Officer
Brigham and Women’s Hospital
18 Francis St
Boston, MA, USA
Dear Sir/Madam,
I wish to apply for the post of Consultant Radiologist as advertised in the
European Journal of Radiology of 22 October.
I enclose my CV and the names of two referees as requested.
Yours faithfully,
Albert Mas, MD
Other Letters
Asking for Permission to Use Someone’s Name as a Referee
Platero Heredia, 19
Córdoba 14012
17 April 2006
John G. Adams, MD
Department of Radiology
Massachusetts General Hospital
22 Beacon St
Boston, MA, USA
Dear Dr. Adams,
I am applying for a post of Consultant Radiologist at Brigham and Women’s Hospital. I should be most grateful if you allow me to use your name
as a referee.
Guido Andreotti, MD
Postponing the Commencement of Duties
Gran Vía, 113
Madrid, 28004
17 November 2006
Robert H. Shaw, MD
Department of Radiology
Massachusetts General Hospital
22 Beacon St
Boston, MA, USA
Dear Dr. Shaw,
I would like to thank you for your letter of 11 February 2001 offering me
the post of Consultant Cardiologist from 12 March 2001.
I am very pleased to accept the post but unfortunately I will not be able to
arrive in Boston until 25 March 2001 due to personal reasons. Would it,
therefore, be possible for you to postpone the commencement of my duties
to 26 March 2001?
I look forward to hearing from you.
Yours sincerely,
Angela Maldini, MD
Unit IV Letters to Editors of Radiological Journals
In Summary
To sum up, a few simple formal details must be recalled:
• “Dear Dr. Smith,” is the usual way to begin an academic letter. Recall
that after the name of the editor you must insert a comma instead of a
semicolon, and continue the letter with a new paragraph.
• The usual formula “find enclosed ...” can nowadays be replaced by “find
attached ...” taking into consideration that most papers are submitted
via the internet.
• “I look forward to hearing from you” is a standard sentence at the end
of any formal letter and you have to bear in mind, in order to avoid a
usual mistake, that “to” is a preposition to be followed by a gerund
rather than the infinitive particle of the verb that follows it. Do not
make the usual mistake of writing “I look forward to hear from you”.
Similar formulas are: “I look forward to receiving your comments on
...”, “Very truly yours,’
• “Your consideration is appreciated” or “Thank you for your and the reviewers’ consideration” are standard sentences to be written at the end
of letters to editors.
• “I look forward to receiving your feedback on ...” is a bit more casual
formula commonly used in letters to editors.
• “Yours faithfully,” is used when you do not know the name of the person
you are writing to, whereas “sincerely,”, “sincerely yours,”, “yours sincerely,” or “very truly yours'’ must be written when you address the letter to a person by name. Therefore, if the letter begins with “Dear Dr.
Olsen,” it must end up with “yours sincerely,” and if it is addressed to
the editor as such it mu5t finish with “yours faithfully,”. Don’t forget that
after the adverb or the pronoun you must insert a comma, rather than a
period, and, then, your signature below.
• Whenever you cannot address one of the editors’ suggestions explain
why it was not possible in the re-submission letter so the reviewers do
not waste time looking for it in the manuscript. For example:
- We have inCluded the techniCal parameters of our imaging protocol
although it has not been possible to expand the teChnical Section as
suggested by reviewer no. 1 due to space limitation.
���� �
Unit V Attending an International
Radiological €ourse
In the following pages we take a look inside international radiological
meetings. We recommend upper-intermediate English speakers to quickly
go over them and intermediate English speakers to review this section
thoroughly in order to become familiar with the jargon of international
congresses and that of the conversational scenarios such as the airport,
plane, customs, taxi, hotel checking-in, and finally the course itself that
make up the usual itinerary of a radiologist attending an international
Most beginners do not go alone to their first courses abroad. This fact,
which in principle is a relief since they do not have to cope with the idiomatic difficulties on their own, has an important drawback: most non-native English-speaking radiology residents come back to their respective
countries without having uttered a single word in English. Although it may
be considered quite unnatural, to speak in English with your colleagues is
the only way of speaking in English during the course since over 90% of
your conversations are going to be those you have with your fellow countrymen. In parties of more than two people, it’s virtually impossible to do
this simple exercise.
Traveling alone is the only way of speaking English during an international radiological course and, for non-native English speaking-radiologists, may be the only opportunity of keeping their English alive throughout the year. Do not waste this excellent opportunity to maintain your level
of both colloquial English and radiological English.
The following anecdote illustrates the level of uncertainty young non-native English-speaking radiologists face when they attend their first international meetings. It was my first European Congress of Radiology in Vienna. When I was expecting to be attended to at the registration desk and
given my congress bag, somebody asked me: “Have you got your badge?”.
Not knowing what badge meant I said “no” since I was unlikely to have
something on me I did not even know the name of. The next sentence I
heard was uttered in a very commanding voice: “Go to that line” so I obediently got into the line without knowing what on earth I was going to get
from it. This was the first, but not the last, time I was in a line without
Unit V Attending an International Radiological Course
having the slightest idea of what I was going to get from it. When this happens to you and you are supposed to give a lecture on, let’s say, MRI of hepatocarcinoma, your desire to come back home is all that remains intact in
Don’t let your lack of fluency in day-to-day English undermine your
ability to deliver a good or even great presentation. Colloquial English and
radiological English are two different worlds, and in order to be successful
in the latter you must have a sound knowledge of the former.
This chapter provides you with tips and useful sentences in your itinerary to an international radiology course: airport, plane, customs, taxi, hotel
checking in, and finally, the course itself. Unless you have overcome the
conversational hurdles in the scenarios that come before the course, firstly,
you are not going to get to the course venue and, secondly, if you do get to
it you will not feel like delivering your presentation.
Most non-native English-speaking lecturers resign themselves to just
giving the lecture and ... “survive”, forgetting that if they do not enjoy
their lecture, the audience will not enjoy it either. They think that to enjoy
giving a lecture, your native tongue must be English. We strongly disagree
with this point since many speakers do not enjoy their talks in their own
native tongues, and it is our understanding that having a good time delivering a presentation has much more to do with your personality than with
your native tongue.
Travel and Hotel Arrangements
Getting to the Airport
• How can I get to the airport?
• How soon should we be at the airport before take-off
Checking in
• May I have your passport and flight tickets, please? Of course, here
you are.
• Are you Mr. Vida? Right, I am. How do you spell it? V-I-D-A (rehearse the spelling of your last name since if it is not an English one,
you are going to be asked about its spelling many times).
• Here is your boarding card. Your flight leaves from gate 43. Thank
Travel and Hotel Arrangements
• You are only allowed two carry-on items. You’ll have to check in that
larger bag.
Ovestions a Passenger Might Ask
• I want to fly to London leaving this afternoon. Is there a direct flight?
Is it via Zurich?
• Is it direct? Yes, it is direct/No, it is one-stop.
• Is there a stop-over? Yes, You have a stop-over in Berlin.
• How long is the stop-over? About 1 hour.
• Do I have to change planes? Yes, You have to change planes at ...
• How much carry-on luggage am I allowed?
• What weight am I allowed?
• My luggage is overweight. How much more do I need to pay?
• Is a meal served? Yes, lunch will be served during the flight.
• What time does the plane to Chicago leave?
• When does the next flight to Chicago leave?
• Can I get onto the next flight?
• Can I change my flight schedule?
• What’s the departure time?
• Is the plane on time?
• What’s the arrival time?
• Will I be able to make my connection?
• I have misplaced my hand luggage. Where is lost property?
• How much is it to upgrade this ticket to first class?
• I want to change the return flight date from Boston to Madrid to November 30th.
• Is it possible to purchase an open ticket?
• I have missed my flight to New York. When does the next flight leave,
• Can I use the ticket I have or do I need to pay for a new one?
dnnoUncing Changes in an Airline flight
• Our flight to Madrid has been cancelled because of snow.
• Our flight to Chicago has been delayed; however all connecting flights
can be made.
• Flight number 112 to Paris has been cancelled.
• Flight number 1145 has been moved to gate B12.
• Passengers for flight number 112 to London go to gate 7. Hurry up!
Our flight has been called over the loudspeaker.
Unit V Attending an International Radiological Course
At the Boarding Gate
• We will begin boarding soon.
• We are now boarding passengers in rows 24 through 36.
• May I see your boarding card?
Pick up your luggage at the terminal.
Where can I find a luggage cart?
Where is the taxi rank?
Where is the subway stop?
Where is the way out?
Complaining About Lost or Damaged Luggage
My luggage is missing.
One of my bags seems to be missing.
My luggage is damaged.
One of my suitcases has been lost.
Exchange Office
• Where is the exchange office?
• What is the rate for the Dollar?
• Could you change 1000 Euros into Dollars?
€rstoms and Immigration €oiitroi
May I see your passport, please?
Do you have your visa?
What is your nationality?
What is the purpose of your journey? The purpose of my journey is a
holiday, touring, family affairs, studying ...
How long do you plan on staying?
Empty your pockets and put your wallet, keys, mobile phone and coins on this tray.
Remove any metallic object you are carrying and put them on this
Open your laptop.
Take off your shoes. Put them in this tray too.
Travel and Hotel Arrangements
• Do you have anything to declare? No, I don't have anything to declare.
• Do you have anything to declare? No, I only have personal effects.
• Do you have anything to declare? Yes, I am a doctor and I’m carrying
some surgical instruments.
• Do you have anything to declare? Yes, I have bought six bottles of
whisky and four cartons of cigarettes in the duty free.
• How much currency are you bringing into the country? I haven’t got
any foreign currency.
• Open your bag, please.
• I need to examine the contents of your bag.
• May I close my bag? Sure
• Please place your suitcases on the table.
• What do you have in these parcels? Some presents for my wife and
• How much duty do I have to pay?
• Where is the exchange office?
During the Flight
Very few exchanges are likely during a normal flight. If you are familiar
with them you will realize how fluency interferes positively with your
mood. Conversely, if you need a pillow and are not able to ask for it, your
self-confidence will shrink, your neck will hurt, and you will not ask for
anything else during the flight. On my first flight to the States I did not
know how to ask for a pillow and tried to convince myself that I did not
actually need one. When I looked it up in my guide, asked for it, and the
stewardess brought the pillow, I gladly and pleasantly fell asleep.
Do not let lack of fluency spoil an otherwise perfect flight.
• Is there an aisle/window seat free? (I asked for one at the check-in
and they told me I should ask on board just in case there had been a
• Excuse me, you are in my seat. Oh! Sorry, I didn’t notice.
• Fasten your seat belt, please.
• Your life-jacket is under your seat.
• Smoking is not allowed during the flight.
• Please would you bring me a blanket/pillow?
• Is there a business class seat free?
• Can I upgrade to first class on board?
• Would you like a cup of coffee/tea/a glass of soda? A glass of soda,
Unit V Attending an International Radiological Course
• What would you prefer, chicken or beef/fish or meat? Beef/Fish,
• Is there a vegetarian menu?
• Stewardess, I’m feeling bad. Do you have anything for flight-sickness?
Could you bring me another sick-bag, please.
• Stewardess, I have a headache. Do you have an aspirin?
• Stewardess, this gentleman is disturbing me.
In the Taxi (US Cab)
Think for a moment of taking a taxi in your city. How many sentences do
you suppose would be exchanged in normal, and even extraordinary, conditions? I assure you that with fewer than two dozen sentences you will
solve more than ninety per cent of possible situations.
Asking IIIIhere to Get a Taxi
• Where is the nearest taxi rank?
• Where can I get a taxi?
Hi, take me downtown/to the Sheraton hotel, please.
Please would you take me to the Airport?
It is rush hour, I don’t go to the airport.
Sorry, I am not on duty.
It will cost you double fare to leave the city.
I need to go to the Convention Center.
Which way do you want me to take you, via Fifth or Seventh Avenue?
Either one would be OK.
• Is there any surcharge to the airport?
Concerning 5peed in a taxi
To downtown as quick as you can.
Are you in a hurry? Yes, I’m in a hurry.
I’m late; please hurry.
Slow down!
Do you have to drive so fast? There is no need to hurry. I am not in a
rush at all.
Travel and Hotel Arrangements
Concerning Smoking in a Taxi
• Would you mind putting your cigarette out?
• Would you mind not smoking, please?
Asking to Stop and I/Tait
Stop at number 112, please.
Which side of the street?
Do you want me to drop you at the door?
Pull over, I’ll be back in a minute.
Please, wait here a minute.
Stop here.
Concerning the Temperature in a Taxi
Would you please wind your window up? It’s a bit cold.
Could you turn the heat up/down/on/off
Could you turn the air conditioning on/off?
Is the air conditioning/heating on?
How much is it?
How much do I owe you?
Is the tip included?
Do you have change for a twenty/fifty (dollar bill)? Sorry, I don’t
(have any change).
Keep the change.
Would you give me a receipt?
I need a receipt, please.
I think that is too expensive.
They have never charged me this before. Give me a receipt, please.
I think I’ll make a complaint.
Can I pay by credit card? Sure, swipe your card here.
Unit V Attending an International Radiological Course
At the Hotel
Checking In
May I help you?
Hello, I have reserved a room under the name of Dr. Viamonte.
For how many people? Two, my wife and me.
Do you need my ID?
Do you need my credit card?
How long will you be staying? We are staying for a week.
You will have to wait until your room is ready.
Here is your key.
Enjoy your stay. Thank you.
Is there anybody who can help me with my bags?
Do you need a bellboy? Yes, please.
I’ll have someone bring your luggage up.
• Can you double-check that we have a double room with a view of the
beach/city . . .?
• I would like a room at the front/at the rear.
• I would like the quietest room you have.
• I would like a non-smoking room.
• I would like a suite.
• How many beds? I want a double bed/a single bed.
• I asked for two single beds.
• I’d like a king-sized bed.
• I’d like a queen-sized bed.
• We will need a crib for the baby.
• Are all of your rooms en suite? Yes, all of our rooms have a bath or
• Is breakfast included?
• Does the hotel have a car park?
• Do you have a car park nearby?
The Stay
• Can you give me a wake-up call at seven each morning?
• There is no hot water. Would you please send someone to fix it?
• The TV is not working properly. Would you please send someone to
fix it?
Travel and Hotel Arrangements
• The bathtub has no plug. Would you please send someone up with
• The people in the room next to mine are making a racket. Would you
please tell them to keep it down?
• I want to change my room. It’s too noisy.
• What time does breakfast start?
• How can I get to the city center?
• Can we change Euros into Dollars?
• Could you recommend a good restaurant near to the hotel?
• Could you recommend a good restaurant?
• Would you give me the number for room service?
• I will have a cheese omelet, a ham sandwich and an orange juice.
• Are there vending machines available?
• Do you have a fax machine available?
• Do you serve meals?
• Is there a pool/restaurant ...?
• How do I get room service?
• Is there wireless/internet connection?
• The sink is clogged.
• The toilet is running.
• The toilet is leaking.
• My toilet overflowed!
• The toilet doesn’t flush.
• The bath is leaking.
• My bathroom is flooded.
• The bath faucets (UK taps) drip day and night.
• The water is rust-colored.
• The pipes are always banging.
• The water is too hot.
• The water is never hot enough.
• I don’t have any hot water.
Checking Out
How much is it?
Do you accept credit cards?
Can I pay in Dollars/Euros?
I’d like a receipt, please.
What time is checkout? Checkout is at 11 a.m.
I would like to check out.
Is there a penalty for late checkout?
Please would you have my luggage brought down.
Would you please call me a taxi?
How far is the nearest bus stop/subway station?
Unit V Attending an International Radiological Course
Excuse me, there is a mistake on the receipt:
I have had only one breakfast.
I thought breakfast was included.
I have been in a single room.
Have you got a complaints book?
Please would you give me my car keys?
Is there anybody here who can help me with my luggage?
Course Example
General Information
By way of example let’s review some general information concerning a
course program, focusing on those terms that may not be known by beginners.
The official language of the course will be English.
Oress Code
Formal dress is required for the Opening Ceremony and for the Social Dinner. Casual wear is acceptable for all other events and occasions (although
formal dress is customary for lecturers).
Commercial Exhibition
Participants will have the opportunity to visit representatives from pharmaceutical, diagnostic and equipment companies, and publishers at their
stands to discuss new developments and receive up-to-date product information.
Although most beginners don’t talk to salespeople due to their lack of
fluency in English, talking to salespeople in commercial stands is a good
way to practice radiological English and, by the same token, receive up-todate information on equipment and devices you currently use, or will use
in the future, at your institution.
Course Example
disclosure Statements
To avoid commercial bias, speakers have to report whether they have sig—
nificant relationships with industry or not.
As far as commercial relationships with industry are concerned there
are three types of speakers:
1. Speakers (spouses/partners, and planners) who have no reported significant relationships with industry.
2. Speakers who have reported receiving something of “value” from a company whose product is related to the content of their presentations.
3. Speakers who have not provided information about their relationship
with industry.
Name and current posts of the speakers:
• Russel J. Curtin, MD. Staff Radiologist. Division of Neuroradiology,
Beath Israel Deaconess Medical Center, Boston, MA
6uest Faculty
Name and current posts of speakers coming from institutions other than
those organizing the course:
• Fergus B Schwartz, Professor of Radiology and Otolaryngology, Head
and Neck Surgery, New York School of Medicine; New York University
Medical Center, New York, NY
How to Reach ...
Arrival by plane
The international airport is situated about 25 kilometers outside the city.
To reach the city center you can use the:
• City airport train. Every half-hour. Non-stop. 18 minutes from the airport direct to downtown, and from downtown direct to the airport.
Fare: single, EUR 10; return, EUR 18.
• Regional railway, line 6. Travel time: 36 minutes. Frequency: every 30
minutes. Fare: single, EUR 12; return, EUR 20. Get off at “Charles
Square”. From there use the underground line “U7” to “Park Street”.
• Bus. International Airport to ... Charles Square. Travel time: 25 minutes. Fare: EUR 8.
Unit V Attending an International Radiological Course
• Taxi. There is a taxi rank to the south of the arrival hall. A taxi to the
city center costs around EUR 45 (depending on traffic).
Arrival by Train
For detailed information about the timetable you can call ...
At the railway station you can use the underground to reach the city.
Congress venue (where the course is to be held, e.g., hotel, university, convention center ...):
Continental Hotel
32 Park Street, 23089 ...
Phone: .../Fax: ...
E-mail: continentalhotelehhs.com
To reach the venue from the city centre (Charles Square) take the UI underground line (green). Leave the train at Park Street and take the exit
marked Continental Hotel. Traveling time: approximately 10 minutes.
financial Shatters
The common European currency is the Euro.
The weather in ... in December is usually cold with occasional snow. The
daytime temperatures normally range from —5° to +5°C
Generally you will have been registered beforehand and you will not have
to register at the course’s registration counter. If you do have to register at
the congress venue, the following are some of the most usual exchanges
that may take place during registration:
May I have a registration form, please?
Course attendant: Do you want me to fill it out (UK fill it in) for you?
Are you a radiologist?
Are you an ECR member?
Are you attending the full course?
Radiology resident/ No. I’m a radiology resident (radiographer/
Course attendant:
Can I see your chairman’s confirmation letter?
Course Example
Radiology resident/ I Wa5 told it was faxed last week. Would you check
that, please?
I’ll pay by cash/credit card.
Charge it to my credit card.
Would you make out an invoice?
Course attendant:
Do you need an invoice?
Do you want me to draw up an invoice?
Course attendant:
Where should I get my badge?
Join that line.
Registration fees and deadlines
1 September
Full fee member
fi 230.Full fee non-member
fi 420.Resident member*
fi 150.Resident non-member* fi 250.Radiographer*
fi 100.Hospital administrator* fi 100.Single-day ticket
On-site only
Single half-day ticket
On-site only
(Tuesday only)
On-site only
Weekend ticket
(Saturday 07:00
to Sunday 18:00)
On-site only
Industry day ticket
On-site only
Full fee member
Full fee non-member
13 November
I 330.I 540.fi 190.fi 310.fi 140.fi 140.On-site only
On-site only
13 November
fi 450.I 650.fi 260.fi 440.fi 180.fi 180.fi 240.I 80.-
On-site only
fi 360.-
On-site only
On-site only
I 90.!Free of charge!
fi 120.fi 180.I 300.-
Course Planning
The basic idea whenever you attend an international radiology course is
that you must rehearse beforehand those situations that are inevitably
going to happen and, in so doing, you will keep to a minimum embarrassing situations catching you off-guard. If only I had rehearsed (at home!)
the meaning of the word “badge”, I wouldn’t have been caught by surprise
on my first course abroad. Just a few words, set phrases, and collocations
must be known in a radiological course environment and we can assure
Attending ananInternational
Unit V Attending
Table 1. Course plan
Dec 4
Special focus
... meets
Dec S
Special focus
Dec 6
Special focus
... meets
Dec 7
Special focus
Dec 8
Special focus Workshops
Special focus
Special focus
Special focus
interpretation sessions
Special focus
you that knowing them will give you the confidence needed to make your
participation in the course a personal success.
The first piece of advice is: read the program of the course thoroughly
and look up in the dictionary or ask your more experienced colleagues
about the words and concepts you don’t know. Since program is available
before the course starts, go over it at home; you don’t need to read the scientific program at the course’s venue.
“Adjourn” is one of those typical program terms with which one gets familiar once the session is “adjourned”. Although many could think that
Course Example
most terms are going to be integrated and understood by their context,
our intention is to go over those “insignificant” terms that may prevent
you from optimizing your time at the course.
An example of a course plan is presented in Table 1. The course plan may
contain the following elements:
• Satellite symposia: Scientific events sponsored by pharmaceutical firms
where new drugs (mainly contrast media), techniques or devices are
presented to the radiological community.
• Plenary sessiOTlS: These events take place usually at midday gathering all
participants around outstanding members of the radiological community.
• Cases of the day: A number of radiological cases covering different sections of radiology. Participants can submit their diagnosis.
• Categorical courses: An important radiological subject is discussed focusing on the needs of general radiologists.
• RefreSher courses: A concrete topic is reviewed in depth by experts in
that particular field.
• “... meets” sessions: The purpose of these sessions is to forge closer ties
between some invited countries and the congress. There are dedicated
sessions for the radiological communities of these nations to demonstrate the excellence of radiology in their countries to congress attendees.
• Special focus session: The aim of a special focus session is to deal with a
relevant “hot topic”, presented in such a way as to promote debate between the panelists and the audience.
• Image interpretation session: Two panels of distinguished radiologists
share their radiological knowledge with the audience while facing unknown cases.
• Scientific session: The Scientific Committee selects, from all the abstracts
submitted, the most outstanding basic and clinical research work, and
invites the authors to make a presentation of their methods and conclusions (usually not longer than 10 to 15 minutes). A round of questions
and/or comments is usually permitted.
• Adjourn: Close (break or recess) at the end of a session.
Unit V Attending an International Radiological Course
���� ��
Unit VI Giving a Radiological Talk
International radiological conferences are in a universe all of their own. In
this universe, attendees and speakers come from many different countries
with their own cultures and consequently their own habits in terms of behavior and public speaking. However, most speakers set aside, at least partially, their cultural identity to embrace the international medical conference style. This standardization is part of the globalization that we are all
The most widely spoken language is not Chinese, English or Spanish
anymore, but the new phenomenon of broken English. This language is the
result of simplifying English to make it as neutral and understandable as
possible, removing colloquial idioms, regional expressions or any other
source of linguistic confusion.
In this new universe, health-care professionals find themselves having to
make a conscious effort to adapt to these explicit and implicit rules. Some
of them are discussed in the following sections.
Having read this chapter you will not only be able to improve your presentations or feel at ease giving them, but you might also actually end up
being able to convey your message and, who knows? ... you might even enjoy it — even if you have to deliver your presentation in the graveyard slot
(the graveyard slot is the first presentation after lunch when most of the
audience will be suffering from postprandial somnolence and very likely
you will not hear a sound except for snores).
Dos and Don’ts
Time is also a very cultural thing. This peculiarity should be taken into
account. Eight o’clock in the morning might seem an early start in Latin
America but a perfectly normal starting time in northern Europe and the
US. Furthermore, the day is divided differently in various parts of the
world ... and in our radiological universe. Thus at an international conference the day is divided into:
• The morning: from the start time to noon.
• The afternoon: from 12:01 to 17:00 or 18:00.
• The evening: from 18:00 to midnight.
Unit VI Giving a Radiological Talk
• Do remember to follow these tips:
- Good morning: from the start time to 12:00.
— tsood afternoon: from 12:01 onwards, even though your metabolism is
far from feeling afternoon-ish until your usual lunch time has gone
by and is begging you to say “good morning”.
- Good evening: from 18:00 onwards. Note that if we have to give a presentation, make a speech or offer a toast at 22:00, we should never begin with “good night”; that should be reserved only for when we are
going to bed. So “good night” is not supposed to be said in public.
When giving a presentation, there is always a time limit. I understand, and
have actually experienced myself, how difficult it is to cram all we have to
say about the topic which we have been researching over the last few years
into a mere 20 minutes. In view of this time constraint, there are various
alternatives ranging from speaking as fast as the tongue can rattle, to cutting it down to 5 minutes and spending the other 15 minutes vacantly gazing at the audience. American, British and Australian physicians are often
extremely fluent speakers (we know, we know ... they are using their
mother tongue). However, remember that showing and commenting on five
slides a minute and speaking faster than can be registered on a digital recorder might not be the best way of conveying a message.
• Don’t speak too fast or too slowly.
• Don’t say sorry for this slide. Since you are the one who chooses the
slides to be presented, get rid of those you would have to apologize for.
• Do summarize your presentation and rehearse to see how long you need
for a clear delivery.
Sometimes lecturers tend to give too much data and minor details in their
presentations. Their introduction is often full of information that is of little
relevance to the international audience (for example, the name, date and
code of local, provincial, regional and national laws regulating radiological
standards in his/her institution; or even the background information on
the main researchers of a trial including their graduation year and shoe
size ... or a full history of the 16th Century building where the hospital
stands today and subsequent restorations it has undergone; etc). In these
cases, by the time all these details have been given and the presentation
has passed the introduction stage, time is up and the chairperson starts
making desperate signs to the speaker.
• Do grab the pointer with both hands.
The best way of avoiding a trembling pointer is to grab it with both hands
and place them over the lectern. If this doesn’t work, we recommend using
the mouse since, at least, your trembling will be confined to one plane instead of the three-dimensional shaking of a laser pointer.
Dos and Don’ts
• Do u5e either a pointer or the computer’s mouse.
Although it may seem unbelievable, I attended a lecture in which the presenter instead of using a laser pointer directed the audience’s attention to
the images using a folded newspaper. The only person who could see the
details the speaker was pointing out was the speaker himself.
• Do structure your presentation so that you convey a few clear messages
instead of a huge amount of not-so-relevant information which nobody
has a chance to take in.
• Don’t read slides, but instead try to explain a few basic ideas as clearly
as possible.
Many intermediate English-speaking doctors could not agree with this
point because they can only feel some confidence if they read the presentation. Reading is the least-natural means of communicating experiences; we
encourage you to present your paper without reading it. Although it will
need much more intensive preparation, the delivery will be more fluid and
— why not? — even brilliant. Many foreign doctors resign themselves to delivering just acceptable talks and explicitly reject the possibility of making
a presentation at the same level as they would in their own language. Do
not reject the possibility of being as brilliant as you would be in your own
language; the only difference is in the amount of rehearsal. Thorough rehearsal can provide you with amazing results; do not give up beforehand.
• Don’t read your presentation from a script.
Even worse than reading slides is to read from a script. I have witnessed
complete messes happening to lecturers who tried, without any success at
all, to coordinate scribbled pages on the lectern and slides. The noise of
the passing pages was unbearable and the face of a speaker on the verge of
a mental breakdown kept the audience from listening to the presentation
• Do enjoy yourself.
When giving the presentation, relax; nobody knows more than you do
about the specific subject that you are presenting. The only way to make
people enjoy your presentation is by enjoying it yourself. You only have to
communicate, not to perform; being a good researcher or a competent clinician is not the same thing as being a stand-up comedian or a model. This
does not mean that we can afford to overlook our presentation skills, especially if you want most of your colleagues to still be awake at the end of
your presentation!
• Do try to overcome stage fright and focus on communicating.
Unit VI Giving a Radiological Talk
There must be somebody out there interested in what you have to say ...
either to praise it or to tear it to pieces, but that doesn’t matter.
• Do avoid anything that would make you nervous when giving your presentation.
One piece of advice is to remove all keys, coins or other metal objects from
your pockets so that you are not tempted to rattle them around — a truly
irritating noise that we have all learned to hate.
• Do put your cell phone (UK mobile phone) and beeper on silent.
The only thing more embarrassing than an attendee’s cell phone interrupting your lecture is your own phone ringing in the middle of your talk.
• Do make sure that your jokes can be understood internationally.
Creativity and humor are always appreciated in a lecture hall ... providing
they are both appropriate and understood! We all know that humor is a
very cultural thing, like time keeping, ties, food preferences, etc. Almost all
American speakers will start their presentation with a joke that most Europeans will not understand, not even the Irish or British. A British speaker
will probably throw in the most sarcastic comment when you are least expecting it and in the same tone as if he or she were telling you about the
mortality rate in his or her unit. A foreign (neither American nor British)
doctor might just try to tell a long joke in English based on a play on
words in his or her mother tongue which obviously doesn’t work in English, and possibly involves religion, sport and/or sex (as a general rule
avoid religious and sex jokes in public presentations).
Useful Sentences for Radiological Talks
Introducing the Presentation
• Good afternoon. It is an honor to have the opportunity to speak to
you about ...
• Good afternoon. Thank you for your kind introduction. It is my pleasure to speak to you about an area of great interest to me.
• In the next few minutes I’ll talk about ...
• The topic I’ll cover this afternoon is ...
• In the next 20 minutes I’ll show you ...
• In my talk on focal hepatic lesions, I want to share with you all our
experience on ...
• Thank you for sticking around (informal way of addressing the last
talk attendees).
Useful Sentences for Radiological Talks
I’d like to thank you Dr. Ho for his kind invitation.
Thank you Dr. Wilson for inviting me to attend this course.
Thank you Dr. Olsen. It is a great honor to be here talking about ...
On behalf of my colleagues and assistants, I want to thank Dr. Smith
for his kind invitation.
I’d like to welcome you to this course on ... (to be said in the first
talk of the course if you are a member of the organizing committee)
Today, I want to talk to you about ...
Now, allow me to introduce ...
What I want to talk about this morning is ...
During the next few minutes, I’d like to draw your attention to
First of all, let me summarize the contents of my lecture on ...
Let’s begin by looking at these 3D images of the heart ...
Commenting on Images, Graphs, Tables, Schematic Representations ...
As you can see in the image on your right ...
As you will see in the next table ...
As we saw in the previous slide ...
The next image shows . .
The next image allows us to ...
In the bottom left image we can see ...
What do we have to look at here?
What do we have to bear in mind with regard to this artifact?
Notice how the lesion borders are ...
Bear in mind that this image was obtained in less than 10 seconds ...
Let’s look at this schematic representation of the portal vein ...
As you can see in this CT image ...
Let us have a look at this schematic diagram of the portal system ...
Looking at this table, you can see ...
Having a look at this bar chart, we could conclude that ...
To sum up, let’s look at this diagram ...
The image on your right ...
The image at the top of the screen shows ...
Let’s turn to the next slide in which the lesion, after the administration of contra5t material, is more conspicuou5 ...
• Figure 7 brings out the importance of ...
• As can be observed in this MR image ...
• I apologize that the faint area of sclerosis in the femur does not project well. (When a subtle finding is difficult to see on a projected image, it is said that it does not project well.)
Unit VI Giving a Radiological Talk
• On the left of the screen is a T2-weighted image at the level of the
pons. On the right of the screen there is a magnified view of the abnormality.
Summing Up
To sum up we can say that ...
In summary, we have discussed
To conclude ...
Summing up, I would say that ...
The take-home lesson of the talk is ...
To put it in a nutshell ...
To cut a long story short ...
In short, ...
To put it briefly ...
Be that as it may, we have to bear in mind that ...
If there is one point I hope you will take away from this presentation,
it is that ...
CT ha5 proven to be very useful in the assessment of lung cancer by
providing additional information during image interpretation.
Cardiac CT is a powerful technique that yields valuable diagnostic information.
The rate of growth and distribution of cardiac CT will depend on investing in technology, training, and collaboration.
MRI may be helpful in the management of ... if sonography is inconclusive.
Virtual colonoscopy is the most accurate technique for the assessment
• Thank you for your kind attention.
• Thank you all for sticking around until the very last talk of the session.
• Thank you all.
• Thank you very much for your time, you have been a most gracious
• Thank you for your attention. I would be happy to entertain any
• Thank you for your time. I would be happy to address any questions.
The Dreadful questions and Comments Section
• This is all we have time for, so thank you and have a good time in
• Let me finish my presentation by saying that ...
• We can say to conclude that ...
• Let me end by wi5hing you a pleasant stay in our city.
• I’d be happy to answer any question you might have.
• I’d be happy to addres5 your comments and questions.
• Ignore lesions less than 4 mm in your reports.
The Dreadful Questions and Comments Section
Many beginners would not hesitate to deliver a free communication at an
international congress if there were not a short section of questions after
This anecdote may illustrate the feelings of many non-native Englishspeaking radiologists in their first presentations in English.
After a short free communication on the MR follow-up of Ross operation (the surgical replacement of a patient’s aortic valve by the pulmonary
valve and the replacement of the latter by a homograft) which had so far
gone reasonably well for a beginner, I was waiting, like a rabbit staring at
a snake, for the round of questions that inevitably followed my presentation.
On the very verge of a mental breakdown, I listened to an English radiologist asking me a question I could barely understand. I told him: “would
you please repeat your question?”, and he, obediently, repeated the question with exactly the same words and the same pace with which he had
formulated it before. As I could not understand the question the second
time, the chairman roughly translated it into a more international and easily understandable English and I finally answered it. This was the only
question I was asked since the time was over and there was no room for
any other comment.
Let us think about this anecdote in a positive way by dissecting it into the
following points which will lead us to some recommendations.
1. Do not be discouraged. Nobody told you that beginnings were easy.
2. Questions and comments by native English speakers tend to be more
difficult to understand.
3. There are several types of interlocutors you must be aware of.
4. Do not complain if the interlocutor does exactly what you asked him/her
5. Chairmen can always help you.
6. Time is limited and you can take advantage of this fact.
Unit VI Giving a Radiological Talk
These points lead to some recommendations:
1. I did not know by then that the worst was still to come. I wasted the
whole morning recreating the scene over and over. “How could I have
spoiled so many hours of research and study? I even thought that people
recognized me as “the one who didn’t understand a simple query ...”
Let us think for a moment how you performed the first time you did
anything in your life, i.e., the first time you grabbed a tennis racquet or
a golf club. In comparison to that it was not that bad.
2. When the radiologist who asked for the microphone is a non-native
English speaker you can begin to feel better since you are going to talk
to an equal with regard to language, to one who has spent a great number of hours fighting to learn a language other than his own. On the
other hand, when you have to deal with a native English speaker there
are two main types of interlocutors.
Type A is a colleague who does not take advantage of being a native
English speaker and reduces his normal rhythm of speech so you can
understand the question and, therefore, convey to the audience whatever
you have to say.
Type B is a colleague who does not make any allowance for the difference between native and non-native English lecturers. Needless to say, I
faced a type B interlocutor in my first international presentation.
3. Types of interlocutors:
• Type 1: The interlocutor who wants to know a particular detail of
your presentation. These interlocutors are easy to handle by just answering their questions.
What diameters do you measure in the aortic root?
Annulus, Valsalva sinuses, and sinotubular junction.
• Type 2: The interlocutor who wants the audience to notice his sound
knowledge of the subject which is being discussed. These interlocutors are quite easy to handle as well since they do not formulate questions as such but make a point of their own. The replies tend to be
shorter than the questions/comments and time, which runs in favor
of the beginner provided he is not speaking, goes by, leaving no room
for another dreadful question.
I do agree with your comments
We are planning to include this point in our next paper on ...
• Type 5: The interlocutor who strongly disagrees with your points. This
is obviously the most difficult to handle for a beginner due to the
scarcity of his idiomatic resources. The only piece of advice is none
other than that you must defend your points from a humble position
and do not ever challenge your interlocutor.
The Dreadful questions and Comments Section
I will consider your Suggestions on ...
ThlS l5 a Work in progress and we will consider including your suggeStions ...
4. If I had requested my interlocutor to ask his question again more slowly
and in a different way so I could understand it he would have been morally obliged to do so. But beginners lack this kind of modesty and pretend to be better and know more than they actually are and do, which
is, by definition, a mistake.
I don’t understand your question. Would you please reformulate your
question in a different way, please?
5. When you feel you need some help, ask the chairman to help you out.
Dr. Ho (chairman) I’m not sure I’ve understood the question. Would you
please formulate it in a different way?
6. It is, at worst, 1 minute of stress. Do not let such a short period of time
prevent you from a potentially successful career in international radiology.
Sentences That May Help
Go over these sentences that may help you escape from a difficult situation
and minimize your fear of the questions and comments section:
taking Your Point
• Let me point out that signal intensity is paramount in order to differentiate ...
• You must bear in mind that this 3D reconstruction was obtained ...
• If you look closely at this brain tumor, you will realize that ...
• I want to draw your attention to the fact that ...
• Don’t forget the importance of SPIO in ...
• Before I move on to my next slide . .
• In view of the upcoming publication of ...
• Radiologically speaking ...
• From a radiological point of view ...
• As far as trackability is concerned ...
• The bottom line of the subject is ...
Unit VI Giving a Radiological Talk
Giving Explanations
• To put it another way, chemical shift artifact was responsible for ...
• Taking into consideration that the study was done under conscious
sedation ...
• In a bit more detail, you can notice that ...
• This fact can be explained taking into account that ...
• SNR (signal-to-noise ratio) was poor since the patient could not hold
his breath.
• Although double phospho-soda was well tolerated by most patients ...
• In short, you may need larger balloons in elderly patients.
• What I’m saying is that endometriosis is related to ectopic growth of
endometrial tissue ...
• We did not administer contrast material because the patient refused
• We perform an unenhanced CT scan because the patient suffered from
renal insufficiency.
AnsweringM •!•*"RIe gvestions
• There are two different questions here.
• It seems there are three questions here.
• It is my understanding that there are two questions to be addressed
• With regard to your first question ...
• Regarding your second question ...
• As far as your first question is concerned ...
• Answering your first question, I should say that ...
• I’ll begin with your second question.
• Let me address your last question first.
• I’ll address your last question first and then the rest of them.
• Would you please repeat your second question?
• I didn’t understand your first question. Would you repeat it?
• With all due respect, I believe that there is no evidence of ...
• To the best of our knowledge no article has been published on this
• With all respect, I think that your point overlooks the main aspect of
• Yours is an interesting point of view, but I’m not sure of its ...
The Dreadful questions and Comments Section
I see it from a different point of view.
With all respect, I don’t go along with you on ...
I think that the importance of ... cannot be denied.
I strongly disagree with your comment on ...
I disagree with your point.
I don’t see a valid argument for supporting such a comment.
Emphasizing a Point
I do believe that ...
I strongly agree with Dr. Ho’s comments on ...
It is of paramount importance ...
It is a crucial fact that ...
And this fact cannot be overlooked.
I’d like to stress the importance of ...
Don’t underestimate the role of ...
The use of iodinated contrast material in these case5 is Of the utmost
• With regard to ..., you must always bear in mind that ...
• It is well known that ...
I’m not sure I understood your question ...
Sorry; I don’t quite follow you.
Would you repeat the question, please?
Would you repeat the second part of your question, please?
I’m afraid I still don’t understand.
Could you be a bit more specific with regard to ...?
What do you mean by ...?
Could you repeat your question? I couldn’t hear you.
Could you formulate your question in a different way?
I’m not sure I understand your final question.
Playing for time
• I am not sure I understood your question. Would you repeat it?
• I don’t understand your questions. Would you formulate it in a different way?
• That’s a very interesting question ...
• I wonder if you could be a bit more specific about ...
Unit VI Giving a Radiological Talk
• I’m glad you asked that question.
• Your question is of the utmost importance, but I’m afraid it is beyond
the scope of our paper ...
• What aspect of the problem are you referring to by saying ...
Evading an Issue
• I’m afraid I’m not really in a position to be able to address your question yet.
• We’ll come back to that in a minute, if you don’t mind.
• I don’t think we have enough time to discuss your comments in
• It would take extremely long time to answer that.
• I will address your question in my second talk, if you don’t mind.
• At my institution, we do not have experience on ...
• At our department, we do not perform ...
• Perhaps we could return to that at the end of the session.
• We’ll probably address your question in further papers on the subject.
• I have no experience ...
Technical Problems
• May I have another laser pointer?
• Does anyone in the audience have a pointer?
• Video images are not running properly. In the meantime I’d like to
comment on ...
• My microphone is not working properly. May I have it fixed?
• My microphone is not working properly. May I use yours?
• Can you hear me?
• Can the rows at the back hear me?
• Can you guys at the back see the screen?
• Can we turn off the lights please?
The Dreadful questions and Comments Section
���� ���
Unit VII €hairing a Radiological
Chairing sessions at international meetings usually comes up when you
have reached a certain level in your academic career. To reach this point
many papers will have been submitted and many presentations will have
been given, so the chances are your level of medical English will be above
that of the target audience of this manual.
Why, then, do we include a section on chairing a session?
We include it because contrary to what many of those who have never
chaired a session in an international meeting may think, even an experienced chairperson may face difficult, even embarrassing situations.
For those who have never chaired a session, to be a chairman means,
firstly, not having to prepare a presentation, and, secondly, the use of simple sentences such as “thank you, Dr. Vida, for your interesting presentation” or “the next speaker will be Dr. Jones who comes from ...”.
In our opinion, being a chairperson means much more than one who
has never chaired them might think. To begin with, a chairperson must go
over not one presentation but thoroughly study all the recently published
material on the subject under discussion. On top of that, a chairperson
must review all the abstracts and must have prepared questions just in case
the audience has no questions or comments.
We have divided this section into four subsections:
Usual chairperson’s comments.
Should chairpersons ask questions?
What the chairperson should say when something is going wrong.
Specific radiological chairperson’s comments
Usual Chairperson’s Comments
Everybody who has attended an international meeting is aware of the usual
sentences the chairperson uses to introduce the session. Certain key expressions will provide you with a sense of fluency without which chairing
a session would be troublesome. The good news is that if you know the
key sentences and use them appropriately, chairing a session is easy. The
bad news is that if, on the contrary, you do not know these expressions, a
Unit VII Chairing a Radiological Session
theoretically simple ta5k will become an embarrassing situation. There i5
always a first time for everything, and if it is the first time you have been
invited to chair a session, rehearse some of these sentences and you will
feel quite comfortable. Accept this piece of advice: only “rehearsed spontaneity” looks spontaneous if you are a beginner.
Introducing the Session
We suggest the following useful comments for introducing the session:
• Good morning ladies and gentlemen. My name is Dr. Vida and I want
to welcome you all to this workshop on congenital heart disease imaging. My co-chair is Dr. Vick who comes from King’s College.
• Good afternoon. The session on MRI in cardiomyopathies is about to
start. Please take a seat and disconnect your cellular phones and any
other electrical devices which could interfere with the oral presentations.
We will listen to ten six-minute lectures with a two-minute period for
questions and comments after each, and afterwards, provided we are still
on time, we will have a last round of questions and comments from the
audience, speakers and panelists.
• Good morning. We will proceed with the session on fibroid embolization. As many papers have to be delivered I encourage the speakers to
keep an eye on the time.
Introducing Speakers
We suggest the following useful comments for introducing speakers:
• Our first speaker is Dr. Vida from Reina Sofia Hospital in Cordoba,
Spain, who will present the paper: “MR evaluation of focal splenic lesions”.
The following speakers are introduced almost the same way with sentences
such as:
• Our next lecturer is Dr. Adams. Dr. Adams comes from Brigham and
Women’s Hospital. Harvard Medical School, and his presentation is entitled “Diagnosis of intraosseous ganglion”.
• Next is Dr. Shaw from Beth Israel Deaconess Hospital, presenting “MR
approaches to molecular imaging”.
• Dr. Olsen from UCSF is the next and last speaker. His presentation is:
“Metastatic disease. Pathways to the heart”.
Usual Chairperson’s Comments
Once the speakers finish their presentation, the chairperson is supposed to
say something like:
• Thank you Dr. Vida for your excellent presentation. Any questions or
The chairperson usually comments on presentations, although sometimes
they do not:
• Thank you Dr. Vida for your presentation. Are there any questions or
comments from the audience?
There are some common adjectives (niCe, elegant, outstanding, excellent,
interesting, clear, accurate ...) and formulas that are usually used to describe presentations. These are illustrated in the following comments:
• Thanks Dr. Shaw for your accurate presentation. Does the audience have
any comments?
• Thank you very much for your clear presentation on this always controversial topic. I would like to ask a question. May I? (Although being the
chairperson you are the one who gives permission, to ask the speaker is
a usual formality.)
• I’d like to thank you for this excellent talk Dr. Olsen. Any questions?
• Thanks a lot for your talk Dr. Ho. I wonder if the audience has got any
We suggest the following useful comments for adjourning the session:
I think we all are a bit tired so we’ll have a short break.
The session is adjourned until 4 p.m.
We’ll take a short break.
We’ll take a 30-minute break. Please fill out the evaluation forms.
The session is adjourned until tomorrow morning. Enjoy your stay in
Finishing the Session
We suggest the following useful comments for finishing the session:
• I’d like to thank all the speakers and the audience for your interesting
presentations and comments. (I’ll) see you all at the congress dinner
and awards ceremony.
• The session is over. I want to thank all the participants for their contribution. (I’ll) see you tomorrow morning. Remember to take your attendance certificates if you have not taken them already.
• We should finish up over here. We’ll resume at 10:50.
Unit VII Chairing a Radiological Session
Should Chairpersons Ask Questions?
In our opinion, chairpersons are supposed to ask questions especially at
the beginning of the session when the audience does not usually make any
comments at all. Warming-up the session is one of the chairperson’s duties,
and if nobody in the audience is in the mood to ask questions the chairperson must invite the audience to participate:
• Are there any questions?
Nobody raises their hand:
• Well, I have got two questions for Dr. Adams. Do you think MR is the
imaging method of choice for the detection and characterization of focal
splenic lesions? and second: What should be, in your opinion, the role of
CT and ultrasound in this diagnostic algorithm?
Once the session has been warmed-up, the chairperson should only ask
questions or add comments as a tool to manage the timing of the session,
so that, if as usual, the session is behind schedule, the chairperson is not
required to participate unless strictly necessary.
The chairperson does not have to demonstrate to the audience his or
her knowledge on the discussed topics by asking too many questions or
making comments. The chairperson’s knowledge of the subject is not in
doubt since without it he or she would not have been selected to chair.
What the Chairperson Should Say when Something
is Going Wrong
Behind Schedule
Many lecturers, knowing beforehand they have a certain amount of time to
deliver their presentations, try to talk a little bit more, stealing time from
the questions/comments time and from later speakers. Chairpersons should
cut short this tendency at the very first chance:
• Dr. Berlusconi, your time is almost over. You have got 30 seconds to finish your presentation.
• Dr. Ho, you are running out of time.
If the speaker does not finish his presentation on time, the chairperson
may say:
• Dr. Berlusconi, I’m sorry but your time is over. We must proceed to the
next presentation. Any questions, comments?
What the Chairperson Should Say when Something is Going Wrong
After introducing the next speaker, sentences such as the following will
help you handle the session:
• Dr. Goyen, please keep an eye on the time, we are behind schedule.
• We are far from being ahead of schedule, so I remind all speakers you
have six minutes to deliver your presentation.
Ahead of Schedule
Although unusual, sometimes there is some extra time and this is a good
chance to ask the panelists a general question about their experience at
their respective institutions:
• As we are a little bit ahead of schedule, I encourage the panelists and
the audience to ask questions and offer comments.
• I have got a question for the panelists: What percentage of the total
number of CMRs at your institution are performed on children?
Technical Problems
Computer Not i¥orkiny
We suggest the following comments:
• I am afraid there is a technical problem with the computer. In the meantime I would like to make a comment about .
• The computer is not working properly. While it is being fixed I encourage the panelists to offer their always interesting comments.
Lights done Out
We suggest the following comments:
• The lights have gone out. We’ll take a hopefully short break until they
are repaired.
• As you see, or indeed do not see at all, the lights have gone out. The hotel staff have told us it is going to be a matter of minutes so do not go
too far; we’ll resume as soon as possible.
Sound done Off
We suggest the following comments:
• Dr. Hoffman, we cannot hear you. There must be a problem with your
• Perhaps you could try this microphone?
• Please would you use the microphone, the rows at the back cannot hear
Unit VII Chairing a Radiological Session
Lecturer Lacks Confidence
If the lecturer is speaking too quietly:
• Dr. Smith would you please speak up? The audience cannot hear you.
• Dr. Alvarez would you please speak up a bit? The people at the back
cannot hear you.
If the lecturer is so nervous he/she cannot go on delivering the presentation:
• Dr. Olsen, take your time. We can proceed to the next presentation, so
whenever you feel OK and ready to deliver yours, it will be a pleasure to
listen to it.
Specific Radiological Chairperson’s Comments
Since chairpersons are supposed to fill in the gaps in the session, if a technical problem occurs, the chairperson must say something “to entertain”
the audience in the meantime. This fact would not create any problem to a
native English speaker but may be troublesome for a non-native Englishspeaking chairperson. In these situations there is an always helpful topic to
be addressed “in the meantime”, namely, the current situation of what is
discussed in the session in the panelists’ countries.
Regarding CMR, how are things going in Italy, Dr. Toldo?
As for as the use of SPIO, what’s the deal in Japan, Dr. Hashimoto?
How is the current situation in Germany regarding repayment policies?
May I ask how many SMR studies you are performing yearly at your respective institutions?
• What’s going on in the States, Dr. Olsen?
By opening a discussion on how things are going in different countries,
the not-too-fluent chairperson shares the burden of filling in the gaps with
the panelists. This trick rarely fails and once the technical problem is fixed
the session can go on normally with nobody in the audience noticing the
lack of fluency of the chairperson.
Besides the usual expressions chairpersons of whatever medical specialty
have to be aware of, there are typical comments a radiological chairperson
should be familiar with. These comments vary depending upon the radiological subspecialty of the chairperson and are, generally speaking, easy to
deal with for even non-native English speakers. By way of example, let’s review the following:
• Dr. Petit, would you please use the pointer so the audience know what
lesion you are talking about?
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Unit VIII Usual Mistakes Made
by Radiologists Speaking and Writing
in English
In this section we try to share with you what we have found to be some of the
great hurdles in radiological English. There are many things that certainly
can go wrong when one is asked to give a lecture in English or whenever
one is supposed to communicate in radiological English. This is by no means
an exhaustive account, it is just a way of passing on what we have learnt from
our own experience in the fascinating world of radiological English.
When preparing and actually delivering a presentation in English at an
international radiological conference, a series of basic issues should be
taken into account. We have grouped them into four danger zones, in the
hope that their classification will make them become less of a problem.
The categories are the following:
Misnomers and false friends
Common grammatical mistakes
Common spelling mistakes
Common pronunciation mistakes.
Misnomers and False Friends
Every tongue has its own false friends. A thorough review of false friends
is beyond the scope of this manual, and we suggest that you look for those
tricky names that sound similar in your language and in English but have
completely different meanings.
Think, for example, about the term graft versus host disease. The translation of host has not been correct in some romance languages, and in
Spanish the term host, which in this context means recipient, has been
translated as huésped which means person staying in another’s house. Many
Spanish medical students have problems with the understanding of this
disease because of the terminology used. Taking into account that what actually happens is that the graft reacts against the recipient, if the disease
had been named graft versus reCipient disease, the concept would probably
be more precisely conveyed.
So from now on, identify false friends in your own language and make a
list beginning with those belonging to your specialty; it is no use knowing
false friends in a language different from your own.
Unit VIII Usual Mistakes Made by Radiologists Speaking and Writing in English
Medicine, in general, and anatomy and radiology in particular, are full
of misnomers. Think for a moment about the term Superficial femoral vein.
It is difficult to explain how a superficial femoral vein clot is actually in
the deep venous system.
Many radiologists and oncologists all over the world say small (mediastinal) lymphadenopathies. Taking into account that size is the only criterion for the diagnosis of abnormal lymph nodes (the usefulness of USPIO in
the diagnosis of lymphadenopathies is beyond the scope of this manual)
and that lymphadenopathy means, from an etymological point of view, abnormal lymph node, a “normnf” (SlTiall size) lymphadenopathy is as absurd
as a normal psychopathy. The term lymphadenomegaly would probably be
a more accurate one.
Etymologically pancreas means all meat, but there is no muscle at all in
that endocrine and exocrine gland.
Why do we call the innermost part of the elbow which is medial and
slightly proximal to the trochlea the medial epicondyle instead of epitrochlea!
Etymologically azygos means odd which puts hemiazygos in a strange
situation since odd numbers are not divisible by two.
The term innominate vein is as absurd as naming a baby unnamed.
Common Grammatical Mistakes
These are some of the most common mistakes made by radiologists speaking in English:
1. The axial fast spin echo T2 image through the patella showed an enlarged and thickened medial patellar plica.
MR images have by definition T1, PD, and T2 information so, after the
predominant weighting, the use of “-weighted image” is imperative. The
correct sentence would be:
• The axial fast spin echo T2-weighted image through the patella
showed an enlarged and thickened medial patellar plica.
2. The intact posterior cruciate ligament was isointense and presented no
signs of disruption.
Isointensity is always a relative magnitude so the correct sentence in this
case would be:
• The intact posterior cruciate ligament was isointense to cortical bone
and showed no signs of disruption.
3. The cyst was hyperintense in T2-weighted images.
Although you may have seen this expression in some talks, it is more
correct to say:
• The cyst was hyperintense on T2-weighted images.
Common Grammatical Mistakes
4. A MR magnet was purchased by the hospital.
Although a magnetic resonance magnet ... is correct, when you use the
acronym do not forget that “m” is read “em” which starts with a vowel,
so the article to be used is “an” instead of “a”. In this case you should
• An MR magnet was purchased by the hospital.
5. The chairman of radiology came from an university hospital.
Although university starts with a vowel, and you may think the article
which must precede it is “an” as in “an airport”, the “u” is pronounced
“you” which starts with a consonant, so the article to be used is “a” instead of “an”. In this case you should write:
• The chairman of radiology came from a university hospital.
6. A 22-years-old man presenting ...
Many times the first sentence of the first slide of a presentation contains
the first error. For those lecturers at an intermediate level, this simple
mistake is so evident that they barely believe it is one of the most frequent mistakes ever made.
It is quite obvious that the adjective 22-year-old cannot be written in the
plural and it should be written:
• A 22-year-old man presenting ...
7. There was not biopsy of the lesion.
This is a frequent and relatively subtle mistake made by upper-intermediate speakers. If you still prefer the use of the negative form you
should say:
• There was not any biopsy of the lesion.
But the affirmative form is:
• There was no biopsy of the lesion.
8. It allows to distinguish between ...
You should use one of the following phrases:
• It allows us to distinguish between ...
• It allows the distinction between ...
9. Haemorrhagic tumors can cause.
Check your paper or presentation for inconsistency in the use of American and British English.
This example shows a sentence made up of an American English word
(tumors) and a British English word (haemorrhagic). So choose American or British spelling depending on the journal or congress you are
sending your paper to.
The sentence should read:
• Haemorrhagic tumours can cause.
• Hemorrhagic tumors can cause.
Unit VIII Usual Mistakes Made by Radiologists Speaking and Writing in English
10. Please would you tell me where is the IR suite?
Embedded questions are always troublesome. Whenever a question is
embedded in another interrogative sentence its word order changes.
This happens when, trying to be polite, we incorrectly change What
time iS it? to WOuld you please tell me what time is it? instead of to
Would you please tell me what time it is?
The direct question where is the IR suite? must be transformed to its
embedded form as follows:
• Please would you tell me where the IR suite is?
11. Most of the times hemangiomas ...
You can say many times but not most of the times. MOSt Of the time is
correct and you can use commonly or frequently as equivalent terms.
Say instead:
• Most of the time hemangiomas ...
12. I look forward to hear from you.
This a very frequent mistake at the end of formal letters such as those
sent to editors. The mistake is based upon a grammatical error. To may
be either a part of the infinitive or a preposition. In this case fo is not
a part of the infinitive of the verb hear but a part of the prepositional
verb look forward to, it is indeed a preposition.
There may be irreparable consequences of making this mistake. If you
are trying to have an article published in a prestigious journal you
cannot make formal mistakes which can preclude the reading of your
otherwise interesting article.
So instead of look forward to hear from you, you should write:
• I look forward to hearing from you.
13. Best regards.
Although it is used in both academic and informal correspondence best
regards is a mixture of two strong English collocations: kind regards
and best wishes. In our opinion instead of best regards, which is colloquially acceptable, you should write:
• Kind regards
or simply
• Regards.
14. Are you suffering from paresthesias?
Many doctors forget that patients are not colleagues and use medical
terminology which cannot be understood by them. This technical question would be easily understood in the form:
• Do you have pins and needles?
15. A unique metastases was seen in the liver.
Unique and metastases are incompatible terms since the former refers
to singular and the latter to plural. Therefore, the appropriate sentence
should have been:
• A unique metastasis was seen in the liver.
Common Grammatical Mistakes
16. Multiple metastasis were seen in the brain.
Multiple and metastases are incompatible terms since the former refers
to plural and the latter to singular. Whenever you use a Latin term
check its singular and plural. Metastasis is singular whereas metastases
is plural so that there are multiple metastasis is not correct. In this
case, you should write:
• Multiple metastases were seen in the brain.
17. An European expert on cardiac MR chaired the session.
Although European starts with a vowel and you may think the article
which must precede it is “an” as in “an airport”, the correct sentence,
in this case, would be:
• A European expert on cardiac MR chaired the session.
18. The meeting began a hour ago.
Although hour starts with a consonant and you may think the article
which must precede it is “a” as in “a cradle”, the correct sentence, in
this case, would be:
• The meeting began an hour ago.
Words starting with a silent “h” are preceded by “an” as if they started
with a vowel.
19. The cardiac surgeon who asked for the CMR was operating the stenotic
aortic valve reported as such by the radiologist.
This sentence is not correct since the verb “to operate” when is used
from a surgical point of view (with regard to both patients and parts of
the anatomy) is always followed by the preposition “on”. The correct
sentence would have been:
• The cardiac surgeon who asked for the CMR was operating on the
stenotic aortic valve reported as such by the radiologist.
20. Medial and collateral ligaments are well defined on the coronal plane.
We use “in” when talking about planes (coronal, axial, sagittal ...) since
the radiological finding is within the image. So, although acceptable, it
would have been better to say:
• Medial and collateral ligaments are well defined in the coronal plane.
21. The hospital personal are very kind.
When we talk about a group of people working at an institution, the
correct word is “personnel”, not “personal”:
• The hospital personnel are very kind.
22. Page to the cardiologist.
The verb “to page” which could be related to the substantive “page” (a
boy who is employed to run errands) is not a prepositional verb and
does not need the preposition “to” after it. When you want the cardiologist paged you must say:
• Page the cardiologist.
Unit VIII Usual Mistakes Made by Radiologists Speaking and Writing in English
23. She works in the neurorradiology division.
This is a common mistake made by Spanish and Latin American radiologists. In English, neuroradiology is written with one “r”:
• She works in the neuroradiology division.
Common Spelling Mistakes
Create your own list of potentially misspelled words and don’t hesitate to
write down you own mnemonic if it helps you.
The following is a list of commonly misspelled words (with the most common misspelling given in parentheses):
• Parallel (misspelled: paralell)
For this frequently misspelled word, I use this quite absurd (as most mnemonics are) mnemonic to recall the spelling: “two Legs (11) run faster, and
get forward, than one (1)”.
• Appearance (misspelled: apperance)
We’ve seen this mistake more than once in radiological drafts. The only
thing you have to check to avoid it is that the verb “appear” is embedded
in the word “appearance”
• Sagittal (misspelled: saggital)
In a word with double consonants and single consonants, avoid doubling
the single consonant and vice versa. Sagittal is one of the most commonly
misspelled words in radiological slides. Words such as sagittal are among
the most frequently used in radiology. The etymology of this word is sagita
which means “arrow”.
• Dura mater (misspelled: dura matter)
Etymologically “mater” means “mother” and is written with one “t”. “Dura
matter” is a common mistake based upon the mixing up of “dura mater”
and “gray/white matter”. “Matter” means substance and has nothing to do
with “mater”.
• Arrhythmia (misspelled: arrhytmia)
Double-check the spelling of arrhythmia and be sure that the word
“rhythm” from which it is derived is embedded in it.
Review the following further pairs of words (with the misspelling given
in parentheses) and, more importantly, as we said above, create your own
list of “troublesome” words.
Common Pronunciation
Grammatical Mistakes
Professor (misspelled: proffesor)
Professional (misspelled: proffesional)
Occasion (misspelled: ocassion)
Dissection (misspelled: disection)
Resection (misspelled: ressection)
Gray-white matter (misspelled: gray-white mater)
Subtraction (misspelled: sub5traction)
Acquisition (misspelled: adquisition)
Common Pronunciation Mistakes
For simplicity, we have taken the liberty of using an approximate representation of the pronunciation instead of using the phonetic signs. We apologize to our linguist colleagues who may have preferred a more orthodox
Pronunciation is one of the most dreaded nightmares of English.
Although there are pronunciation rules, there are so many exceptions that
you must know the pronunciation of most words by ear. Therefore, firstly,
read out loud as much as you can because it is the only way you will notice the unknown words with regard to pronunciation, and secondly, when
you attend a course, besides concentrating on the presentation itself, focus
on the way native-English-speaking radiologists pronounce the words you
do not know.
With regard to pronunciation, we recommend that you should:
• Not be afraid of sounding different or funny. English sounds are different and funny. Sometimes a non-native-speaking radiologist may know
how to pronounce a word correctly but is a bit ashamed of doing so,
particularly in the presence colleagues of the same nationality. Do not
be ashamed of pronouncing correctly independently of the nationality of
your interlocutor.
• Enjoy the effort of using a different set of muscles in the mouth. In the
beginning the “English muscles” may become stiff and even hurt, but
persevere, this is only a sign of hard work.
• Not worry about having a broad or even embarrassing accent in the beginning; it doesn’t matter as long as you are understood. The idea is to
communicate, to say what you think or feel, and not to give a performance in speech therapy.
• Try to pronounce English words properly. As time goes by and you begin to feel relatively confident about your English, we encourage you to
progressively and thoroughly study English phonetics. Bear in mind that
if you keep your pronunciation as it was at the beginning you will sound
like American or British people do when speaking your language with
their unmistakable accent.
Unit VIII Usual Mistakes Made by Radiologists Speaking and Writing in English
• Rehearse standard collocations in both conversational and radiological
scenarios. Saying straightforward things such as “Do you know what I
mean?” or “Would you do me a favor?” and “Who’s on call today? Please
would you window (and level) this image?” will provide you with extremely useful fluency tools.
Having your own Subtle national accent in English is not a serious problem
as long as the presentation conveys the correct message. However, as far as
pronunciation is concerned, there are several tricky words that cannot be
properly named false friends and need some extra attention.
In English there are some words that are spelled differently but sound
very much the same. Consider the following, for example:
• Ileum: the distal portion of the small intestine, extending from the jejunum to the cecum.
• Ilium: the uppermost and widest of the three sections of the hip bone.
Imagine for a moment how surreal it would be for our surgeons to mix up
the bowel with the hip bone. Well, I suppose you could say it could be
worse — at least both anatomical structures are roughly in the same area!
Again, consider the following:
The English word tear means two different things according to how we
pronounce it:
• If tear [tiar] is pronounced, we mean the watery secretion of the lacrimal glands which serves to moisten the conjunctiva.
• If tear [tear] is pronounced, we are referring to the action of wounding
or injuring, especially by ripping apart as in “there is a longitudinal tear
in the posterior horn of the internal meniscus”.
Among the radiological words mO5t Commonly mispronounced are two
which deserve a close analysis since radiologists use (or misuse) them almost every single day of their professional life. These two words are: “radiology” and “image”.
Many radiologists worldwide say they are a [ra-dio-lo-gist], “I am a
radiologist”, instead of [rei-dio-lo-gist]. A similar difficulty occurs with intrinsically radiological words such as radiology, radiographics, radiological
. Please, from now on, avoid this unbelievably frequent mistake.
Image and images are two of the most commonly mispronounced radiological words. Can you imagine how many times you will say “image” or
“images” in your radiological life? Please don’t say [inn-éich] or [im-éiches] but [inn-ich] and [inn-iches]. If you are among the vast group of radiologists who used to say [im-éich] for every single slide of every presentation, don’t tell anybody and “keep on” saying [inn-ich] “as you always did”.
Don’t worry! there are probably no records of your presentations, and if
they do exist, they are not readily available.
Common Pronunciation
Grammatical Mistakes
The reason for underlining these two common mistakes is to emphasize
that you have to avoid mispronunciation mistakes beginning with the most
usual words in your daily practice. If you are not a chest radiologist and
don’t know how to pronounce, for example, “lymphangioleiomyomatosis”,
don’t worry about this word until you have mastered the pronunciation of
your day-to-day radiological terms (if you had to read out loud this weird
word, you can defend yourself by saying LAM [lam] which, by the way,
sounds more natural and is much more used than [lim-fan-gio-lio-maio- matou-ses]).
Our piece of advice is: create a top-100 list with your day-to—day most
difficult words in terms of spelling. Once you are familiar with them enlarge your list by keeping on reading out loud as many articles as you can.
If you happen to be an interventional radiologist, brochures and instructions-for-use sheets can keep you posted with virtually no effort and will
help you to fill in those useless time-outs between patients.
We have created a list made up of some mispronounced radiological
words. Since this list is absolutely arbitrary and could vary depending on
your native tongue, we encourage you to create your own list.
• Parenchyma
Parenchyma is, in principle, an easy word to pronounce. We include it
in this list because we’ve noticed that some lecturers, particularly Italians, tend to say [pa-ren-kài-ma].
• The letter “h”
— “Non-pronunciation”: Italian and French speakers tend to skip this
letter so that when they pronounce the word “enhancement” they say
[en-àns-ment] instead of [en-hàns-ment]. It is true that “h” can be silent but NOT always.
— “Over-pronunciation”: Spanish doctors tend to over-pronounce the
letter “h”.
• Data
Although some American radiologists say [data], the correct pronunciation of this word is [déi-ta].
• Disease/decease
The pronunciation of disease can be funny since depending on how you
pronounce the “s” you can be saying “decease” which is what terminal
diseases end in. The correct pronunciation of disease is [di-ssiss] with a
liquid “s”; if you say [di-sis] with a plain “s”, as many Spanish and Latin
American speakers do, every time you talk about, let’s say, Alzheimer’s
disease you are talking about Alzheimer’s decease or Alzheimer’s death.
• Chamber
The pronunciation of chamber is somewhat tricky since French speakers
tend “Gallicize” it by saying [cham-bre] whereas some Spanish speakers
say simply [cham-ber] instead of [cheim-ber]
Unit VIII Usual Mistakes Made by Radiologists Speaking and Writing in English
• French words such as “technique”
In English you have to say [tek-nik], “in the French way”, although you
say technical [ték-ni-cal].
• Hippocampus (think of hippopotamus)
A lack of etymological knowledge is responsible for this tricky mistake.
Many doctors worldwide say [haipo-carn-pus] as if they were talking
about the hypothalamus [haipo-ta-la-mus]. Unfortunately, hippocampus
has no etymological relationship to hypothalamus or hypotension. Hippo- means “horse” (as in hippopotamus) and is pronounced [hipo-càmpus].
• Director
Although you can say both [di-rect] and [dai-rect] only [dai-rec-tor] is
correct; you cannot say [di-rec-tor].
It is beyond the scope of this manual to go over all potentially tricky words
in terms of pronunciation, but we offer below a short list of more such
words, and would again encourage you to create your own “personal” list.
Medulla [me-dú-la]
Anesthetist [a-nés-te-tist]
Gynecology [gai-ne-có-lo-gy]
Edema [i-di-ma]
Case report [kéis ri-pórt, NOT kéis ré-port]
Multidetector [multi-, NOT mul-tai]
Oblique [o-blík, NOT o—blàik]
Femoral [fí-mo-ral]
Jugular [iu-gu-lar]
Triquetrum [tri-kui-trum]
Common Grammatical Mistakes
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Unit IX Latin and €reek Terminology
Latin and Greek terminology is another obstacle to be overcome on our
way to becoming fluent in medical English. Romance-language speakers
(Spanish, French, Italian ...) are undoubtedly at an advantage, although
this advantage can become a great drawback in terms of pronunciation
and, particularly, in the use of the plural forms of Latin and Greek.
Since most Latin words used in medical English keep the Latin plural
ending — e.g., metastasis, pl. metastases; viscus, pl. viscera — it is essential
to understand the basis of plural rules in Latin.
All Latin nouns and adjectives have different endings for each gender
(masculine, feminine, or neuter), number (singular or plural), and case —
the case is a special ending that reveals the function of the word in a particular sentence. Latin adjectives must correlate with the nouns they modify in case, number, and gender. Although we can barely remember it from
our days in high school, there are five different patterns of endings, each
one of them is called declension.
The nominative case indicates the subject of a sentence. The genitive
case denotes possession or attachment. Dropping the genitive singular ending gives the base to which the nominative plural ending is added to build
the medical English plural form.
For example:
• Corpus (nominative singular), corporis (genitive singular), corpora (nominative plural). This is a third-declension neuter noun that means
body. The corresponding forms for the accompanying adjective callosus
are callO5um, and callosa, respectively. Thus corpus callosum (nominative, singular, neuter), corpora callosa (nominative, plural, neuter).
Another example:
• Coxa vnrn (feminine singular), coxae varae (feminine plural), but genu
vnruri (neuter, singular), genua vara (neuter, plural)
Unit IX Latin and Greek Terminology
Table 1. The endings of Latin substantives listed by case and declension
Nominative -a
Genitive sing. -oe
Nominative -ae
This unit provides an extensive Latin glossary that includes the singular
and plural nominative, and the genitive singular forms of each word as well
as the declension and gender of each word. In some terms, additional items
have been added, such as English plural endings when widely accepted
(e.g., fetus, Latin plural feti, English plural fetuses), and Greek-origin endings kept in some Latin words (e.g., thorax, pl. thoraces, gen. thoracos/ thoracis: chest)
The endings of Latin substantives listed by case and declension are
shown in Table 1.
• 1st declension:
— Feminine words: patella (nom. sing.), patellae (gen.), patellae (nom.
pl.). English patella.
• 2nd declension:
— Masculine words: humerus (nom. sing.), humeri (gen.), humeri (nom.
pl.). English humerus.
— Neuter words: interstitium (nom. sing.), interstitii (gen.), interstitia
(nom. pl.). English interstice.
• 3rd declension:
— Masculine or feminine words: pars (nom. sing.), partis (gen.), partes
(nom. pl.). English part.
— Neuter words: os (nom. sing.), oris (gen.), ora (nom. pl.). English
• 4th declension:
— Masculine words: processus (nom. sing.), processus (gen.), processus
(nom. pl.). English proCess.
— Neuter words: cornu (nom. sing.), Cornus (gen.), cornua (nom. pl.).
English horn.
Plural Rules
• 5th declension:
— Feminine words: faCies (nom. sing.), faciei (gen.), faCies (nom. p1.).
English face.
The endings of the adjectives change according to one of these two patterns:
1. Singular: masc. -us, fem. -n, neut. -Bm. Plural: masc. -i, fem. -ne, neut. -n.
2. Singular: masc. -is, fem. -is, neut. -e. Plural: masc. -es, fem. -es, neut. -a.
Plural Rules
It is far from our intention to replace medical dictionaries and Latin or
Greek text books. Conversely, this unit is aimed at giving some tips related
to Latin and Greek terminology that can provide a consistent approach to
this challenging topic.
Our first piece of advice on this subject is that whenever you write a Latin or Greek word, firstly, check its spelling and, secondly, if the word you
want to write is a plural one, never make it up. Although guessing the
plural form could be acceptable as an exercise in itself, double-check the
word by looking it up in a medical dictionary.
The following plural rules are useful to at least give us self-confidence in
the use of usual Latin or Greek terms such as metastasis — metastases, pelVIS — pelves, bronchus — bronchi, etc. ...
Some overseas doctors do think that metastasis and metastases are
equivalent terms, and they are absolutely wrong; the difference between a
unique liver metastasis and multiple liver metastases is so obvious that no
additional comment is needed.
There are many Latin and Greek words whose singular forms are almost
never used as well as Latin and Greek terms whose plural forms are seldom said or written. Let us think, for example, about the singular form of
viscera (V iSCHS). Very few physicians are aware that the liver is a viscus
whereas the liver and spleen are visCera. From a cOlloquial standpoint this
discussion might be considered futile, but those who write papers do know
that Latin/Greek terminology is always a nightmare and needs thorough revision, and that terms seldom used on a day-to-day basis have to be properly written in a scientific article. Again, let us consider the plural form of
pelvis (pelves). To talk about several pelves is so rare that many doctors
have never wondered what the plural form of pelvis is.
Although there are some exceptions, the following general rules can be
helpful with plural terms:
• Words ending in -uS change to -i (2nd declension masculine words):
— bronchus — bronchi
Unit IX Latin and Greek Terminology
• Words ending in -um change to -n (2nd declension neuter words):
- aCetabulum - acetabula
• Words ending in -o change to -ae (1st declension feminine words):
- vena - venae
• Words ending in -ma change to -mata or -mas (3rd declension neuter
words of Greek origin):
— S0fC0IJJ0 — SOFC0lTtata/SafCOlTtOS
• Words ending in -is change to -es (3rd declension masculine or feminine
— metastasis - metastases
• Words ending in -itis change to -itides (3rd declension masculine or
feminine words):
— arthritis — arthritides
• Words ending in -x change to -ces (3rd declension masculine or feminine words):
— pneumothorax — pneumothoraces
• Words ending in -cyx change to -cyges (3rd declension masculine or
feminine words):
— COCC yx — Coccyges
• Words ending in -ion change to -in (2nd declension neuter words, most
of Greek origin):
— criterion — criteria
List of Latin and Greek Terms and Their Plurals
adj. adjective
Engl. English
fern. feminine
gen. genitive
Gr. Greek
Lat. Latin
masc. masculine
neut. neuter
Sing. singular
List of Latin and Greek Terms and Their Plurals
• Abdomen, p1. abdomina, gen. abdominis. Abdomen. 3rd declension
• Abducens, pl. abducentes, gen. abducentis (from the verb abduco, to detach, to lead away). 3rd declension.
• Abductor, pl. abductores, gen. abductoris (from the verb abduco, to detach, to lead away). 3rd declension masc.
• Acetabulum, pl. acetabula, gen. acetabuli. Cotyle. 2nd declension neut.
• Acinus, pl. acini, gen. acini. Acinus. 2nd declension masc.
• Adductor, pl. adductores, gen. adductoris. Adductor. 3rd declension
• Aditus, pl. aditus, gen. aditus. Entrance to a cavity. 4th declension masc.
— Aditus ad antrum, aditus glottidis inferior, etc.
• Agger, pl. aggeres, gen. aggeris. Prominence. 3rd declension masc.
- Agger valvae venae, agger nasi, agger perpendicularis, etc.
• Ala, pl. alae, gen. alae. Wing. 1st declension fern.
• Alveolus, pl. alveoli, gen. alveoli. Alveolus (lit. basin). 2nd declension
• Alveus, pl. alvei, gen. alvei. Cavity, hollow. 2nd declension masc.
• Amoeba, pl. amoebae, gen. amoebae. Ameba. 1st declension fern.
• Ampulla, pl. ampullae, gen. ampullae. Ampoule, blister. 1st declension
• Anastomosis, pl. anastomoses, gen. anastomosis. Anastomosis. 3rd declension.
• Angulus, pl. anguli, gen. anguli. Angle, apex, corner. 2nd declension neut.
• Annulus, pl. annuli, gen. annuli. Ring. 2nd declension masc.
• Ansa, pl. ansae, gen. ansae. Loop, hook, handle. 1st declension fern.
• Anterior, pl. anteriores, gen. anterioris. Foremost, that is before, former.
3rd declension ma5C.
• Antrum, p1. antra, gen. antri. Antrum, hollow, cave. 2nd declension
• Anus, pl. ani, gen. ani. Anus (lit. ring). 2nd declension masc.
• Aorta, pl. Aortae, gen. aortae. Aorta. 1st declension fern.
• Apex, pl. apices, gen. apices. Apex (top, summit, cap). 3rd declension
• Aphtha, pl. aphthae, gen. aphthae. Aphtha (small ulcer). 1st declension
• Aponeurosis, pl. aponeuroses, gen. aponeurosis. Aponeurosis. 3rd declension.
• Apophysis, pl. apophyses, gen. apophysos/apophysis. Apophysis. 3rd declension fern.
• Apparatus, pl. apparatus, gen. apparatus. Apparatus, system. 4th declension masc.
• Appendix, pl. appendices, gen. appendicis. Appendage. 3rd declension
• Area, pl. areae, gen. areae. Area. 1st declension fern.
Unit IX Latin and Greek Terminology
• Areola, pl. areolae, gen. areolae. Areola (lit. little area). 1st declension
• Arrector, pl. arrectores, gen. arrectoris. Erector, tilt upwards. 3rd declension masc.
• Arteria, pl. arteriae, gen. arteriae. Artery. 1st declension fern.
• Arteriola, pl. arteriolae, gen. arteriolae. Arteriola (small artery). 1st declension fern.
• Arthritis, pl. arthritides, gen. arthritidis. Arthritis. 3rd declension fern.
• Articularis, pl. articulares, gen. articularis. Articular, affecting the
joints. 3rd declension masc. (adj.: masc. artiCularis, fern. articularis,
neut. articulate).
• Articulatio, pl. articulationes, gen. articulationis. Joint. 3rd declension
• Atlas, pl. atlantes, gen. atlantis. First cervical vertebra. 3rd declension
• Atrium, pl. atria, gen. atrii. Atrium. 2nd declension neut.
• Auricula, p1. auriculae, gen. auriculae. Auricula (ear flap). Auricular
(auricular appendix of the cardiac atrium). 1st declension fern.
• Auricularis m., pl. auriculares, gen. auricularis. Pertaining to the ear.
3rd declension masc.
• Auris, pl. aures, gen. auris. Ear. 3rd declension fern.
• Axilla, pl. axillae, gen. axillae. Armpit. 1st declension fern.
• Axis, p1. axes, gen. axis. Second cervical vertebra, axis. 3rd declension
• Bacillus, pl. bacilli, gen. bacilli. Stick-shape bacterium (lit. SlTloll Stick).
2nd declension masc.
• Bacterium, pl. bacteria, gen. bacterii. Bacterium. 2nd declension neut.
• Basis, pl. bases, gen. basis. Basis, base. 3rd declension fern.
• Biceps m., pl. bicipites, gen. bicipitis. A muscle with two heads. 3rd declension masc.
— Biceps + genitive. Biceps brachii (brachium, arm)
• Borborygmus, pl. borborygmi, gen. borborygmi. Borborygmus (gastrointestinal sound). 2nd declension masc.
• Brachium, pl. brachia, gen. brachii. Arm. 2nd declension neut.
• Brevis, pl. breves, gen. brevis. Short, little, small. 3rd declension masc.
(adj.: masc. brevis, fern. brevis, neut. breve).
• Bronchium, pl. bronchia, gen. bronchii. Bronchus. 2nd declension neut.
• Buccinator m., pl. buccinatores, gen. buccinatoris. Buccinator m. (trumpeter’s muscle). 3rd declension ma5C.
• Bulla, pl. bullae, gen. bullae. Bulla. 1st declension fern.
• Bursa, pl. bursae, gen. bursae. Bursa (bag, pouch). 1st declension fern.
List of Latin and Greek Terms and Their Plurals
• Caecum, p1. caeca, gen. caeci. Blind. 2nd declension neut. (adj.: masc.
caecus, fern. caeca, neut. caecum).
• Calcaneus, pl. calcanei, gen. calcanei. Calcaneus (from calx, heel). 2nd
declension masc.
• Calculus, pl. calculi, gen. calculi. Stone (lit. pebble). 2nd declension
• Calix, pl. calices, gen. calicis. Calix (lit. cup, goblet). 3rd declension
• Calx, pl. calces, gen. calcis. Heel. 3rd declension masc.
• Canalis, pl. canales, gen. canalis. Channel, conduit. 3rd declension masc.
• Cancellus, pl. cancelli, gen. cancelli. Reticulum, lattice, grid. 2nd declension masc.
• Cancer, pl. cancera, gen. canceri. Cancer. 3rd declension neut.
• lapillus, pl. capilli, gen. capilli. Hair. 2nd declension masc.
• Capitatus, pl. capitati, gen. capitati. Capitate, having or forming a head.
2nd declension masc. (adj.: masc. capitatus, fern. capitata, neut. capita-
• Capitulum, pl. capitula, gen. capituli. Head of a structure, condyle. 2nd
declension neut.
• Caput, pl. capita, gen. capitis. Head. 3rd declension neut.
• Carcinoma, pl. Lat. carcinomata, pl. Engl. carcinomas, gen. carcinomatis. Carcinoma (epithelial cancer). 3rd declension neut.
• Carina, pl. carinae, gen. carinae. Carina (lit. keel, bottom of ship). 1st
declension fern.
• Cartilago, pl. cartilagines, gen. cartilaginis. Cartilage. 3rd declension
• Cauda, pl. caudae, gen. caudae. Tail. 1st declension fern.
- Cauda equina (adj.: masc. equinus, fern. equina, neut. equinum. Concerning horses).
• Caverna, pl. cavernae, gen. cavernae. Cavern. 1st declension fern.
• Cavitas, pl. cavitates, gen. cavitatis. Cavity. 3rd declension fern.
• Cavum, pl. cava, gen. cavi. Cavum (hole, pit, depression). 2nd declension neut.
• Cella, pl. cellae, gen. cellae. Cell (lit. Cellar, wine storeroom). 1st declension fern.
• Centrum, pl. centra, gen. centri. Center. 2nd declension neut.
• Cerebellum, pl. cerebella, gen. cerebelli. Cerebellum. 2nd declension
• Cerebrum, pl. cerebra, gen. cerebri. Brain. 2nd declension neut.
• Cervix, pl. cervices, gen. cervicis. Neck. 3rd declension fern.
• Chiasma, pl. chiasmata, gen. chiasmatis/chiasmatos. Chiasm. 3rd declension neut.
• Choana, pl. choanae, gen. choanae. Choana. 1st declension fern.
- Choanae narium (naris, gen. sing. naris, gen. pl. narium, nose). Posterior opening of the nasal fossae.
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List of Latin and Greek Terms and Their Plurals
• Corpus, pl. corpora, gen. corporis. Body. 3rd declension neut.
- Corpus callosum, corpus cavernosum.
• Corpusculum, pl. corpuscula, gen. corpusculi. Corpuscle. 2nd declension neut.
• Cortex, pl. cortices, gen. corticis. Cortex, outer covering. 3rd declension
• Coxa, pl. coxae, gen. coxae. Hip. 1st declension fern.
• Cranium, pl. crania, gen. cranii. Skull. 2nd declension neut.
• Crisis, pl. crises, gen. crisos/crisis. Crisis. 3rd declension fern.
• Crista, pl. cristae, gen. cristae. Crest. 1st declension fern.
- CFlSta galli (from gallus, pl. galli, rooster). The midline process of the
ethmoid bone arising from the cribriform plate.
• Crus, pl. crura, gen. cruris. Leg, leg-like structure. 3rd declension neut.
- Crura diaphragmatis.
• Crusta, pl. crustae, gen. crustae. Crust, hard surface. 1st declension fern.
• Crypta, pl. cryptae, gen. cryptae. Crypt. 1st declension fern.
• Cubitus, pl. cubiti, gen. cubiti. Ulna (lit. forearm). 2nd declension masc.
• Cubitus, pl. cubitus, gen. cubitus. State of lying down. 4th declension
- De cubito Supino/ prono.
• Culmen, pl. culmina, gen. culminis. Peak, top. Top of cerebellar lobe.
3rd declension neut.
• Cuneiforme, pl. cuneiformia, gen. cuneiformis. Wedge-shaped structure.
3rd declension neut. (adj.: masc. cuneiformis, fern. cuneiformis, neut. cuneiforme).
• Decussatio, pl. decussationes, gen. decussationis. Decussation. 3rd declension fern.
• Deferens, p1. deferentes, gen. deferentis. Spermatic duct (from the verb
defero, to carry). 3rd declension masc.
• Dens, pl. dentes, gen. dentis. Tooth. 3rd declension masc.
• Dermatitis, pl. dermatitides, gen. dermatitis. Dermatitis. 3rd declension.
• Dermatosis, pl. dermatoses, gen. dermatosis. Dermatosis. 3rd declension.
• Diaphragma, pl. diaphragmata, gen. diaphragmatis. Diaphragm. 3rd declension neut.
• Diaphysis, pl. diaphyses, gen. diaphysis. Shaft. 3rd declension.
• Diarthrosis, pl. diarthroses, gen. diarthrosis. Diarthrosis. 3rd declension.
• Diastema, pl. diastemata, gen. diastematis. Diastema (congenital fissure). 3rd declension.
• Digastricus m., pl. digastrici, gen. digastrici. Digastric (having two bellies). 2nd declension masc.
Unit IX Latin and Greek Terminology
• Digitus, pl. digiti, gen. sing. digiti, gen. pl. digitorum. Finger. 2nd declension mase.
— £xtensor digiti minimi, flexor superficialis digitorum.
• Diverticulum, pl. diverticula, gen. diverticuli. Diverticulum. 2nd declension neut.
• Dorsum, pl. dorsa, gen. dorsi. Back. 2nd declension neut.
• Ductus, pl. ductus, gen. ductus. Duct. 4th declension mase.
- Ductus arteriosus, duCtuS deferens.
• Duodenum, pl. duodena, gen. duodeni. Duodenum (lit. twelve. The duodenum measures 12 times a finger). 2nd declension neut.
• Ecchymosis, pl. ecchymoses, gen. ecchymosis. Ecchymosis. 3rd declension.
• Effluvium, pl. effluvia, gen. effluvii. Effluvium (fall). 2nd declension
• Encephalitis, pl. encephalitides, gen. encephalitidis. Encephalitis. 3rd
declension fern.
• Endocardium, pl. endocardia, gen. endocardii. Endocardium. 2nd declension neut.
• Endometrium, pl. endometria, gen. endometrii. Endometrium. 2nd declension neut.
• Endothelium, pl. endothelia, gen. endothelii. Endothelium. 2nd declension neut.
• Epicondylus, pl. epicondyli, gen. epicondyli. Epicondylus. 2nd declension
• Epidermis, pl. epidermides, gen. epidermidis. Epidermis. 3rd declension.
• Epididymis, pl. epididymes, gen. epididymis. Epididymis. 3rd declension.
• Epiphysis, pl. epiphyses, gen. epiphysis. Epiphysis. 3rd declension.
• Epithelium, pl. epithelia, gen. epithelii. Epithelium. 2nd declension neut.
• Esophagus, pl. esophagi, gen. esophagi. Esophagus. 2nd declension
• Exostosis, pl. exostoses, gen. exostosis. EXO5tOsis. 3rd declension.
• Extensor, pl. extensores, gen. extensoris. A muscle the contraction of
which stretches out a structure. 3rd declension masc.
- Extensor carpi ulnaris m., extensor digitorum communis m., extensor
hallucis longus/brevis m., etc.
• Externus, pl. externi, gen. externi. External, outward. 2nd declension
masc (adj.: masc. externus, fern. externa, gen. externum).
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Unit IX Latin and Greek Terminology
• Furfur, pl. furfures, gen. furfuris. Dandruff. 3rd declension masc.
• Furunculus, p1. furunculi, gen. furunculi. Furuncle. 2nd declension
• Galea, pl. galeae, gen. galeae. Cover, a structure shaped like a helmet
(lit. helmet). 1st declension fern.
- Galea aponeurotiCa, pl. galeae aponeurotiCae (epicranial aponeurosis).
• Ganglion, pl. ganglia, gen. ganglii. Node. 2nd declension masc.
• Geniculum, pl. genicula, gen. geniculi. Geniculum (knee-shaped structure). 2nd declension neut.
• Geniohyoideus m., pl. geniohyoidei, gen. geniohyoidei. Glenohyoid muscle. 2nd declension masc.
• Genu, pl. genua, gen. genus. Knee. 4th declension neut.
• Genus, pl. genera, gen. generis. Gender. 3rd declension neut.
• Gestosis, pl. gestoses, gen. gestosis. Gestosis (pregnancy impairment).
3rd declension.
• Gingiva, pl. gingivae, gen. gingivae. Gum. 1st declension fern.
• Glabella, pl. glabellae, gen. glabellae. Small lump/mass. 1st declension
• Glandula, pl. glandulae, gen. glandulae. Gland. 1st declension fern.
• Glans, pl. glandes, gen. glandis. Glans (lit. acorn). 3rd declension fern.
- Glans penis.
• Globus, pl. globi, gen. globi. Globus, round body. 2nd declension masc.
• Glomerulus, pl. glomeruli, gen. glomeruli. Glomerule. 2nd declension
• Glomus, pl. glomera, gen. glomeris. Glomus (ball-shaped body). 3rd declension.
• Glottis, pl. glottides, gen. glottidis. Glottis. 3rd declension.
• Gluteus m., pl. glutei, gen. glutei. Buttock. 2nd declension masc.
• Gracilis m., pl. graciles, gen. gracilis. Graceful. 3rd declension masc
(adj.: masc. gracilis, fern. gracilis, neut. gracile).
• Granulatio, pl. granulationes, gen. granulationis. Granulation. 3rd declension.
• Gumma, pl. gummata, gen. gummatis. Syphiloma. 3rd declension neut.
• Gutta, p1. guttae, gen. guttae. Gout. 1st declension fern.
• Gyrus, pl. gyri, gen. gyri. Convolution. 2nd declension masc.
• Gastrocnemius m., pl. gastrocnemii, gen. gastrocnemii. Calf muscle.
2nd declension masc.
• Hallux, pl. halluces, gen. hallucis. First toe. 3rd declension masc.
• Hamatus, pl. hamati, gen. hamati. Hamate bone. 2nd declension masc.
(adj.: masc. hamatus, fern. hamata, neut. hamatum. Hooked).
• Hamulus, pl. hamuli, gen. hamuli. Hamulus (lit. small hOOk). 2nd declension masc.
List of Latin and Greek Terms and Their Plurals
• Haustrum, pl. haustra, gen. haustri. Pouch from the lumen of the colon.
2nd declension neut.
• Hiatus, pl. hiatus, gen. hiatus. Gap, cleft. 4th declension masc.
• Hilum, pl. hila, gen. hili. Hilum (the part of an organ where the neurovascular bundle enters). 2nd declension neut.
• Hircus, pl. hirci, gen. hirci. Hircus (armpit hair, lit. goat). 2nd declension masc.
• Humerus, pl. humeri, gen. humeri. Humerus. 2nd declension masc.
• Humor, pl. humores, gen. humoris. Humor, fluid. 3rd declension masc.
• Hypha, pl. hyphae, gen. hyphae. Hypha, tubular cell (lit. Gr. web). 1st
declension fern.
• Hypophysis, pl. hypophyses, gen. hypophysis. Pituitary gland (lit. undergrowth). 3rd declension.
• Hypothenar, pl. hypothenares, gen. hypothenaris. Hypothenar (from Gr.
thenar, the palm of the hand). 3rd declension.
• Ilium, pl. ilia, gen. ilii. Iliac bone. 2nd declension neut.
• In situ. In position (from situs, pl. situs, gen. situs, site). 4th declension
• Incisura, pl. incisurae, gen. incisurae. Incisure (from the verb incido, cut
into). 1st declension fern.
• Incus, pl. incudes, gen. incudis. Incus (lit. anvil). 3rd declension fern.
• Index, pl. indices, gen. indicis. Index (second digit, forefinger), guide.
3rd declension masc.
• Indusium, pl. indusia, gen. indusii. Indusium (membrane, amnion). 2nd
declension neut.
• Inferior, pl. inferiores, gen. inferioris. Inferior. 3rd declension masc.
• Infundibulum, p1. infundibula, gen. infundibuli. Infundibulum. 2nd declension neut.
• Insula, pl. insulae, gen. insulae. Insula. 1st declension fern.
• Intermedius, pl. intermedii, gen. intermedii. In the middlle of. 2nd declension masc. (adj.: masc. intermedius, fern. intermedia, neut. intermedrum)
• Internus, pl. interni, gen. interni. Internal. 2nd declension masc. (adj.:
masc. internus, fern. interna, neut. internum).
• Interosseus, gen. interossei, pl. interossei. Interosseous. 2nd declension
masc. (adj.: masc. interosseus, fern. interossea, neut. interosseum).
• Intersectio, pl. intersectiones, gen. intersectionis. Intersection. 3rd declension fern.
• Interstitium, pl. interstitia, gen. interstitii. Interstice. 2nd declension
• Intestinum, pl. intestina, gen. intestini. Bowel. 2nd declension neut.
• Iris, pl. irides, gen. iridis. Iris. 3rd declension masc.
• Ischium, pl. ischia, gen. ischii. Ischium. 2nd declension neut.
Unit IX Latin and Greek Terminology
• Isthmus, p1. Lat. isthmi, pl. Engl. isthmuses, gen. isthmi. Constriction,
narrrow passage. 2nd declension masc.
• Jejunum, pl. jejuna, gen. jejuni. Jejunum (from Lat. adj. jejBnus, fasting,
empty). 2nd declension neut.
• Jugular, pl. jugulares, gen. jugularis. Jugular vein (lit. relating to the
throat, from Lat. jugulus, throat). 3rd declension.
• Junctura, pl. juncturae, gen. juncturae. Joint, junction. 1st declension
Labium, pl. labia, gen. labii. Lip. 2nd declension neut.
Labrum, pl. labra, gen. labri. Rim, edge, lip. 2nd declension neut.
Lacuna, pl. lacunae, gen. lacunae. Pond, pit, hollow. 1st declension fern.
Lamellipodium, pl. lamellipodia, gen. lamellipodii. Lamellipodium. 2nd
declension neut.
Lamina, pl. laminae, gen. laminae. Layer. 1st declension fern.
— Lamina papyracea, lamina perpendicularis.
Larva, pl. larvae, gen. larvae. Larva. 1st declension fern.
Larynx, pl. Lat. larynges, pl. Engl. larynxes, gen. laryngis. Larynx. 3rd
Lateralis, pl. laterales, gen. lateralis. Lateral. 3rd declension masc. (adj.:
masc. lateralis, fern. lateralis, neut. laterale).
Latissimus, pl. latissimi, gen. latissimi. Very wide, the widest. 2nd declension masc. (adj.: masc. latissimus, fern. latissima, neut. latissimum).
Latus, pl. latera, gen. lateris. Flank. 3rd declension neut.
Latus, pl. lati, gen. lati. Wide, broad. 2nd declension masc. (adj.: masc.
latus, fern. lata, neut. latum).
Lemniscus, p1. lemnisci, gen. lemnisci. Lemniscus (lit. ribbon). 2nd declension masc.
Lentigo, pl. lentigines, gen. lentiginis. Lentigo (lit. lentil-shaped SpOt).
3rd declension.
Levator, pl. levatores, gen. levatoris. Lifter (from Lat. verb levo, to lift).
3rd declension masc.
Lien, pl. lienes, gen. lienis. Spleen. 3rd declension masc.
Lienculus, pl. lienculi, gen. lienculi. Accessory spleen. 2nd declension
Ligamentum, pl. ligamenta, gen. ligamenti. Ligament. 2nd declension
Limbus, pl. limbi, gen. limbi. Border, edge. 2nd declension masc.
Limen, pl. limina, gen. liminis. Threshold. 3rd declension neut.
Linea, pl. lineae, gen. lineae. Line. 1st declension fern.
Lingua, pl. linguae, gen. linguae. Tongue. 1st declension fern.
Lingualis, pl. linguales, gen. lingualis. Relative to the tongue. 3rd declension masc. (adj.: masc. lingualis, fern. lingualis, neut. linguale).
List of Latin and Greek Terms and Their Plurals
• Lingula, pl. lingulae, gen. lingulae. Lingula (tongue-shaped). 1st declension fern.
• Liquor, pl. liquores, gen. liquoris. Fluid. 3rd declension masc.
• Lobulus, pl. lobuli, gen. lobuli. Lobule. 2nd declension masc.
• Lobus, pl. lobi, gen. lobi. Lobe. 2nd declension masc.
• Loculus, pl. loculi, gen. loculi. Loculus (small chamber). 2nd declension
• Locus, pl. loci, gen. loci. Locus (place, position, point). 2nd declension
• Longissimus, pl. longissimi, gen. longissimi. Very long, the longest. 2nd
declension masc. (Adj masc. longissimus, fern. longissima, neut. longissimum).
— LongissimuS dOYSl/ Capitis mm. (long muscle of the back/head)
• Longus, pl. longi, gen. longi. Long. 2nd declension masc. (adj.: masc.
longus, fern. longa, neut. longum).
— Longus colli m. (long muscle of the neck).
• Lumbar, p1. lumbares, gen. lumbaris. Lumbar. 3rd declension.
• Lumbus, pl. lumbi, gen. lumbi. Loin. 2nd declension masc.
• Lumen, pl. lumina, gen. luminis. Lumen. 3rd declension neut.
• Lunatum, pl. lunata, gen. lunati. Lunate bone, crescent-shaped structure.
2nd declension neut. (adj.: masc. lunatus, fern. lunofa, neut. /unafum).
• Lunula, pl. lunulae, gen. lunulae. Lunula. 1st declension fern.
• Lymphonodus, pl. lymphonodi, gen. lymphonodi. Lymph node. 2nd declension masc.
• Macula, pl. maculae, gen. maculae. Macula, spot. 1st declension fern.
• Magnus, pl. magni, gen. magni. Large, great. 2nd declension masc. (adj.:
masc. magnus, fern. magna, neut. magnum).
• Major, pl. majores, gen. majoris. Greater. 3rd declension masc./fem.
• Malleollus, pl. malleoli, gen. malleoli. Malleollus (lit. small hammer).
2nd declension masc.
• Malleus, pl. mallei, gen. mallei. Malleus (lit. hammer). 2nd declension
• Mamilla, pl. mamillae, gen. mamillae. Mamilla. 1st declension fern.
• Mamma, pl. mammae, gen. mammae. Breast. 1st declension fern.
• Mandibula, pl. mandibulae, gen. mandibulae. Jaw. 1st declension fern.
• Mandibular, pl. mandibulares, gen. mandibularis. Relative to the jaw.
3rd declension.
• Manubrium, pl. manubria, gen. manubrii. Manubrium (lit. handle). 2nd
declension neut.
- Manubrium sterni, pl. manubria sterna (superior part of the sternum).
• Manus, pl. manus, gen. manus. Hand. 4th declension fern.
• Margo, pl. margines, gen. marginis. Margin. 3rd declension fern.
• Matrix, pl. matrices, gen. matricis. Matrix (formative portion of a structure, surrounding substance). 3rd declension fern.
Unit IX Latin and Greek Terminology
• Maxilla, pl. maxillae, gen. maxillae. Maxilla. 1st declension fern.
• Maximus, p1. maximi, gen. maximi. The greatest, the biggest, the largest.
2nd declension masc. (adj.: masc. maximus, fern. maxima, neut. maximum).
• Meatus, pl. meatus, gen. meatus. Meatus, canal. 4th declension masc.
• Medialis, pl. mediales, gen. medialis. Medial. 3rd declension masc./fem.
(adj.: masc. mediali5, fern. medialis, neut. mediale)
• Medium, pl. media, gen. medii. Substance, culture medium, means. 2nd
declension neut.
• Medulla, pl. medullae, gen. medullae. Marrow. 1st declension fern.
— Medulla oblongata (caudal portion of the brainstem), medulla spinalis
• Membrana, pl. membranae, gen. membranae. Membrane. 1st declension
• Membrum, pl. membra, gen. membri. Limb. 2nd declension neut.
• Meningitis, pl. meningitides, gen. meningitidis. Meningitis. 3rd declension fern.
• Meningococcus, pl. meningococci, gen. meningococci. Meningococcus.
2nd declension masc.
• Meninx, pl. meninges, gen. meningis. Meninx. 3rd declension.
• Meniscus, pl. menisci, gen. menisci. Meniscus. 2nd declension masc.
• Mentum, pl. menti, gen. menti. Chin. 2nd declension masc.
• Mesocardium, pl. mesocardia, gen. mesocardii. Mesocardium. 2nd declension neut.
• Mesothelium, pl. mesothelia, gen. mesothelii. Mesothelium. 2nd declension neut.
• Metacarpus, pl. metacarpi, gen. metacarpi. Metacarpus. 2nd declension
• Metaphysis, pl. metaphyses, gen. metaphysis. Metaphysis. 3rd declension.
• Metastasis, pl. metastases, gen. metastasis. Metastasis. 3rd declension
• Metatarsus, pl. metatarsi, gen. metatarsi. Metatarsus. 2nd declension
• Microvillus, pl. microvilli, gen. microvilli. Microvillus (from villus,
hair). 2nd declension masc.
• Minimus, pl. minimi, gen. minimi. The smallest, the least. 2nd declension ma5C. (adj,: masc. minimus, fern. minimn, neut. minimum).
• Minor, p1. minores, gen. minoris. Lesser. 3rd declension masc.
• Mitochondrion, pl. mitochondria, gen. mitochondrium. Mitochondrion.
3rd declension neut.
• Mitosis, pl. mitoses, gen. mitosis. Mitosis. 3rd declension (from Gr. mitoe, thread).
• Mons, pl. montes, gen. montis. Mons (lit. mountain). 3rd declension
• Mors, pl. mortes, gen. mortis, acc. mortem. Death. 3rd declension fern.
• Mucolipidosis, pl. mucolipidoses, gen. mucolipidosis. Mucolipidosis. 3rd
declension masc./fem.
List of Latin and Greek Terms and Their Plurals
• Mucro, pl. mucrones, gen. mucronis. Sharp-tipped structure. 3rd declension masc.
— Mucro sterni (sternal xyphoides).
• Musculus, pl. musculi, gen. musculi. Muscle. 2nd declension masc.
• Mycelium, pl. mycelia, gen. mycelii. Mycelium, mass of hyphae. 2nd declension neut.
• Mycoplasma, pl. mycoplasmata, gen. mycoplasmatis. Mycoplasma. 3rd
declension neut.
• Mylohyoideus m., pl. mylohyoidei, gen. mylohyoidei. 2nd declension
• Myocardium, pl. myocardia, gen. myocardii. Myocardium. 2nd declension neut.
• Myofibrilla, pl. myofibrillae, gen. myofibrillae. Myofibrilla. 1st declension fern.
• Myrinx, pl. myringes, gen. myringis. Eardrum. 3rd declension.
• Naris, pl. nares, gen. naris. Nostril. 3rd declension fern.
• Nasus, pl. nasi, gen. nasi. Nose. 2nd declension masc.
• Navicularis, pl. naviculares, gen. navicularis. Ship shaped. 3rd declension masc.
• Nebula, pl. nebulae, gen. nebulae. Mist, cloud (corneal nebula. corneal
opacity). 1st declension fern.
• Neisseria, pl. neisseriae, gen. neisseriae. Neisseria. 1st declension fern.
• Nephritis, pl. nephritides, gen. nephritidis. Nephritis. 3rd declension.
• Nervus, pl. nervi, gen. nervi. Nerve. 2nd declension masc.
• Neuritis, pl. neuritides, gen. neuritidis. Neuritis. 3rd declension.
• Neurosis, pl. neuroses, gen. neurosis. Neurosis. 3rd declension.
• Nevus, pl. nevi, gen. nevi. Nevus (lit. mole on the body, birthmark). 2nd
declension masc.
• Nidus, pl. nidi, gen. nidi. Nidus (lit. nest). 2nd declension masc.
• Nodulus, pl. noduli, gen. noduli. Nodule (small node, knot). 2nd declension masc.
• Nucleolus, pl. nucleoli, gen. nucleoli. Nucleolus (small nucleus). 2nd declension masc.
• Nucleus, pl. nuclei, gen. nuclei. Nucleus (central part, core, lit. inside of
a nut). 2nd declension masc.
• Obliquus, pl. obliqui, gen. obliqui. Oblique. 2nd declension masc. (adj.:
masc. obliquus, fern. obliqua, neut. obliquum).
• Occiput, pl. occipita, gen. occipitis. Occiput (back of the head). 3rd declension neut.
• Oculentum, pl. oculenta, gen. oculenti. Eye ointment. 2nd declension
• Oculus, pl. oculi, gen. oculi. Eye. 2nd declension masc.
Unit IX Latin and Greek Terminology
• Oliva, pl. olivae, gen. olivae. Rounded elevation (lit. olive). 1st declension fern.
• Omentum, p1. omenta, gen. omenti. Peritoneal fold. 2nd declension
• Oogonium, pl. oogonia, gen. oogonii. Oocyte. 2nd declension neut.
• Operculum, pl. opercula, gen. operculi. Operculum, cover (lit. lesser lid).
2nd declension neut.
• Orbicularis m., pl. orbiculares, gen. orbicularis. Muscle encircling a
structure. 3rd declension masc. (adj.: masc. orbicularis, fern. orbicularis,
neut. orbiculare).
• Organum, pl. organa, gen. organi. Organ. 2nd declension neuter.
• Orificium, pl. orificia, gen. orificii. Opening, orifice. 2nd declension
• 0s, pl. ora, gen. oris. Mouth. 3rd declension neut.
• 0s, pl. ossa, gen. ossis. Bone. 3rd declension neut.
— OS + genitive case: oS CoCC yges (coccigeal bone), os iSChii (ischium).
• Ossiculum, pl. ossicula, gen. ossiculi. Ossicle, small bone. 2nd declension masc.
• Ostium, pl. ostia, gen. ostii. Opening into a tubular organ, entrance. 2nd
declension neuter.
• Ovalis, pl. ovales, gen. ovalis. Oval. 3rd declension masc. (adj.: masc.
ovalis, fern. ovalis, neut. ovnfe)
• Ovarium, pl. ovaria, gen. ovarii. Ovary. 2nd declension neut.
• Ovulum, p1. ovula, gen. ovuli. Ovule. 2nd declension neut.
• Palatum, pl. palata, gen. palati. Palate. 2nd declension neut.
• Palma, pl. palmae, gen. palmae. Palm. 1st declension fern.
• Palmaris, pl. palmares, gen. palmaris. Relative to the palm of the hand.
3rd declension masc. (adj.: masc. palmaris, fern. palmaris, neut. palmare).
• Palpebra, pl. palpebrae, gen. palpebrae. Eyelid. 1st declension fern.
• Pancreas, pl. pancreates/pancreata, gen. pancreatis. Pancreas. 3rd declension fern./neut.
• Panniculus, pl. panniculi, gen. panniculi. Panniculus (a layer of tissue,
from pannus, pl. panni, cloth). 2nd declension masc.
• Pannus, pl. panni, gen. panni. Pannus (lit. cloth). 2nd declension masc.
• Papilla, pl. papillae, gen. papillae. Papilla (lit. nipple). 1st declension fern.
• Paralysis, pl. paralyses, gen. paralysos/paralysis. Palsy. 3rd declension fern.
• Parametrium, pl. parametria, gen. parametrii. Parametrium. 2nd declension neut.
• Paries, pl. parietes, gen. parietis. Wall. 3rd declension masc.
• Pars, pl. partes, gen. partis. Part. 3rd declension fern.
• Patella, pl. patellae, gen. patellae. Patella. 1st declension fern.
• Pectoralis m., pl. pectorales, gen. pectoralis. Pectoralis muscle. 3rd declension masc. (adj.: masc. pectoralis, fern. pectoralis, neut. pectorale).
List of Latin and Greek Terms and Their Plurals
• Pectus, pl. pectora, gen. pectoris. Chest. 3rd declension neut.
- PeCtus excavatum, peCtus carinatum.
• Pediculus, pl. pediculi, gen. pediculi. 1. Pedicle. 2. Louse. 2nd declension
• Pedunculus, pl. pedunculi, gen. pedunculi. Pedicle. 2nd declension
• Pelvis, pl. pelves, gen. pelvis. Pelvis. 3rd declension fern.
• Penis, pl. penes, gen. penis. Penis. 3rd declension masc.
• Perforans, pl. perforantes, gen. perforantis. Something which pierces a
structure. 3rd declension masc.
• Pericardium, pl. pericardia, gen. pericardii. Pericardium. 2nd declension
• Perimysium, pl. perimysia, gen. perimysii. Perimysium (from Gr. mysia,
muscle). 2nd declension neut.
• Perineum, pl. perinea, gen. perinei. Perineum. 2nd declension neut.
• Perineurium, pl. perineuria, gen. perineurii. Perineurium (from Gr. neuron, nerve). 2nd declension neut.
• Periodontium, pl. periodontia, gen. periodontii. Periodontium (from Gr.
odous, tooth). 2nd declension neut.
• Perionychium, pl. perionychia, gen. perionychii. Perionychium (from Gr.
onyx, nail). 2nd declension neut.
• Periosteum, pl. periostea, gen. periosteii. Periosteum (from Gr. osteon,
bone). 2nd declension neut.
• Periostosis, pl. periostoses, gen. periostosis. Periostosis. 3rd declension.
• Peritoneum, pl. peritonea, gen. peritonei. Peritoneum. 2nd declension
• Peroneus m., pl. peronei, gen. peronei. Peroneal bone. 2nd declension
• Pes, pl. pedes, gen. pedis. Foot. 3rd declension masc.
• Petechia, pl. petechiae, gen. petechiae. Petechiae (tiny hemorrhagic
spots). 1st declension fern.
• Phalanx, pl. phalanges, gen. phalangis. Phalanx (long bones of the digits). 3rd declension fern.
— OS phalangi, pl. ossa phalangium.
• Phallus, pl. phalli, gen. phalli. Penis. 2nd declension masc.
• Pharynx, p1. pharynges, gen. pharyngis. Pharynx. 3rd declension.
• Philtrum, pl. philtra, gen. philtri. Philtrum. 2nd declension neut.
• Phimosis, p1. phimoses, gen. phimosis. Phimosis. 3rd declension masc.
• Phlyctena, pl. phlyctenae, gen. phlyctenae. Phlyctena (small blister). 1st
declension fern.
• Pia mater, pl. piae matres, gen. piae matris. Pia mater (inner meningeal
layer of tissue). 1st declension fern. (adj.: masc. pius, fern. pia, neut.
pium, tender).
• Placenta, pl. placentae, gen. placentae. Placenta (lit. cake). 1st declension
• Planta, pl. plantae, gen. plantae. Plant, sole. 1st declension fern.
List of Latin and Greek Terms and Their Plurals
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Pulmo, pl. pulmones, gen. pulmonis. Lung. 3rd declension masc.
Punctata, pl. punctatae, gen. puctatae. Pointed. 1st declension fem.
Punctum, pl. puncta, gen. puncti. Point. 2nd declension neut.
Pylorus, pl. pylori, gen. pylori. Pylorus. 2nd declension masc.
Pyramidalis m., pl. pyramidales, gen. pyramidalis. Pyramidal. 3rd declension masc. (adj.: masc. pyramidalis, fem. pyramidalis, neut. pyramidale).
• Pyriformis m., pl. pyriformes, gen. pyriformis. Pear-shaped. 3rd declension masc. (adj.: masc. pyriformis, fem. pyriformis, neut. pyriforme).
• Quadratus, pl. quadrati, gen. quadrati. Square. 2nd declension masc.
(adj.: masc. quadratus, fem. quadrata, neut. quadratum).
• Quadrigemina, pl. quadrigeminae, gen. quadrigeminae. Fourfold, in
four parts. 1st declension fem. (adj.: quadrigeminae, fem. quadrigemina,
neut. quadrigeminum)
• Rachis, pl. Lat. rachides, pl. Engl. rachises, gen. rachidis. Rachis, vertebral column. 3rd declension.
• Radiatio, pl. radiationes, gen. radiationis. Radiation. 3rd declension
• Radius, pl. radii, gen. radii. Radius. 2nd declension masc.
• Radix, pl. radices, gen. radicis. Root, base. 3rd declension fern.
• Ramus, pl. rami, gen. rami. Branch. 2nd declension masc.
• Receptaculum, pl. receptacula, gen. receptaculi. Receptacle, reservoir.
2nd declension neut.
• Recessus, pl. recessus, gen. recessus. Recess. 4th declension masc.
• Rectus, p1. recti, gen. recti. Right, straight (adj.: masc. rectus, fern. reCta,
neut. reCtum).
- Rectus abdominis m.
• Regio, pl. regiones, gen. regionis. Region. 3rd declension fern.
• Ren, pl. renes, gen. renis. Kidney. 3rd declension masc.
• Rete, pl. retia, gen. retis. Network, net. 3rd declension neut.
- Rete mirabilis.
• Reticulum, pl. reticula, gen. reticuli. Reticulum. 2nd declension neut.
• Retinaculum, pl. retinacula, gen. retinaculi. Retinaculum (retaining
band or ligament). 2nd declension neut.
• Rima, pl. rimae, gen. rima. Fissure, slit. 1st declension fern.
• Rostrum, pl. rostra, gen. rostri. Rostrum (beak-shaped structure). 2nd
declension neut.
• Rotundum, pl. rotunda, gen. rotundi. Round declension (adj.: masc. rotundus, fern. rotunda, neut. rotundum).
- Foramen rotundum, pl. foramina rotunda.
• Ruga, pl. rugae, gen. rugae. Wrinkle, fold. 1st declension fern.
List of Latin and Greek Terms and Their Plurals
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Unit IX Latin and Greek Terminology
• Syndesmosis, pl. syndesmoses, gen. syndesmosis. Synde5mosis. 3rd declension.
• Synechia, pl. synechiae, gen. synechiae. Synechia. 1st declension fem.
• Syrinx, pl. syringes, gen. syringis. Syrinx. 3rd declension.
Talus, pl. tali, gen. tali. Talus. 2nd declension masc.
Tarsus, p1. tarsi, gen. tarsi. Tarsus. 2nd declension masc.
Tectum, pl. tecta, gen. tecti. Roof. 2nd declension neut.
Tegmen, pl. tegmina, gen. tegminis. Roof, covering. 3rd declension neut.
Tegmentum, pl. tegmenta, gen. tegmenti. Covering. 2nd declension neut.
Tela, pl. telae, gen. telae. Membrane (lit. web). 1st declension fern.
Telangiectasis, pl. telangiectases, gen. telangiectasis. Telangiectasis. 3rd
Temporalis m., pl. temporales, gen. temporalis. 3rd declension masc.
(adj.: masc. temporalis, fern. temporalis, neut. temporale).
Tenaculum, pl. tenacula, gen. tenaculi. Surgical clamp. 2nd declension
Tendo, pl. tendines, gen. tendinis. Tendon, sinew (from verb tendo,
stretch). 3rd.
Tenia, pl. teniae, gen. teniae. Tenia. 1st declension fern.
Tensor, pl. tensores, gen. tensoris. Something that stretches, that tenses
a muscle. 3rd declension masc.
Tentorium, pl. tentoria, gen. tentorii. Tentorium. 2nd declension neut.
Teres, pl. teretes, gen. teretis. Round and long. 3rd declension masc.
Testis, pl. testes, gen. testis. Testicle. 3rd declension masc.
Thalamus, pl. thalami, gen. thalami. Thalamus (lit. marriage bed). 2nd
declension masc.
Theca, pl. thecae, gen. thecae. Theca, envelope (lit. case, box). 1st declension fern.
Thelium, pl. thelia, gen. thelii. Nipple. 2nd declension neut.
Thenar, pl. thenares, gen. thenaris. Relative to the palm of the hand.
3rd declension neut.
Thesis, pl. theses, gen. thesis. Thesis. 3rd declension fern.
Thorax, pl. thoraces, gen. thoracos/thoracis. Chest. 3rd declension masc.
Thrombosis, pl. thromboses, gen. thombosis. Thrombosis. 3rd declension.
Thrombus, pl. thrombi, gen. thrombi. Thrombus, clot (from Gr. thrombos). 2nd declension masc.
Thymus, pl. thymi, gen. thymi. Thymus. 2nd declension masc.
Tibia, pl. tibiae, gen. tibiae. Tibia. 1st declension fern.
Tonsilla, pl. tonsillae, gen. tonsillae. Tonsil. 1st declension fern.
Tophus, pl. tophi, gen. tophi. Tophus. 2nd declension masc.
Torulus, pl. toruli, gen. toruli. Papilla, small elevation. 2nd declension
Trabecula, pl. trabeculae, gen. trabeculae. Trabecula (supporting bundle
of either osseous or fibrous fibers). 1st declension fern.
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List of Latin and Greek Terms and Their Plurals
Trachea, pl. tracheae, gen. tracheae. Trachea. 1st declen5ion fern.
Tractus, p1. tractus, gen. tractus. Tract. 4th declension masc.
Tragus, pl. tragi, gen. tragi. Tragus, hircus. 2nd declension masc.
Transversalis, pl. transversales, gen. transversalis. Transverse. 3rd declension. (adj.: masc. transversalis, fern. transversalis, neut. transversale).
Transversus, pl. transversi, gen. transversi. Lying across, from side to
side. 2nd declension masc. (adj.: masc. transversus, fern. transversa,
neut. transversum).
Trapezium, pl. trapezia, gen. trapezii. Trapezium bone. 2nd declension
Trauma, pl. traumata, gen. traumatis. Trauma. 3rd declension neut.
Triangularis, pl. triangulares, gen. triangularis. Triangular. 3rd declension masc. (adj.: masc. triangulaYlS, fern. triangularis, neut. triangulare).
Triceps, pl. tricipes, gen. tricipis. Triceps (from ceps, pl. cipes, gen. cipis,
headed). 3rd declension masc.
Trigonum, pl. trigona, gen. trigoni. Trigonum (lit. triangle). 2nd declension neut.
Triquetrum, pl. triquetra, gen. triquetri. Triquetrum, triquetral bone,
pyramidal bone. 2nd declension neut. (adj.: masc. triquetrus, fern. triquetra, neut. triquetrum. Three-cornered, triangular).
Trochlea, pl. trochleae, gen. trochleae. Trochlea (lit. pulley). 1st declension fern.
Truncus, pl. trunci, gen. trunci. Trunk. 2nd declension masc.
Tuba, pl. tubae, gen. tubae. Tube. 1st declension fern.
Tuberculum, pl. tubercula, gen. tuberculi. Tuberculum, swelling, protuberance. 2nd declension neut.
Tubulus, pl. tubuli, gen. tubuli. Tubule. 2nd declension masc.
Tunica, pl. tunicae, gen. tunicae. Tunic. 1st declension fern.
Tylosis, pl. tyloses, gen. tylosis. Tylosis (callosity). 3rd declension.
Tympanum, pl. tympana, gen. tympani. Tympanum, eardrum (lit. small
drum). 2nd declension neut.
Ulcus, pl. ulcera, gen. ulceris. Ulcer. 3rd declension neut.
Ulna, pl. ulnae, gen. ulnae. Ulna (lit. forearm). 1st declension fern.
Umbilicus, p1. umbilici, gen. umbiculi. Navel. 2nd declension masc.
Uncus, pl. unci, gen. unci. Uncus (lit. hook, clamp). 2nd declension
Unguis, pl. ungues, gen. unguis. Nail, claw. 3rd declension masc.
Uterus, pl. uteri, gen. uteri. Uterus, womb. 2nd declension masc.
Utriculus, pl. utriculi, gen. utriculi. Utriculus (lit. wineskin). 2nd declension masc.
Uveitis, pl. uveitides, gen. uveitidis. Uveitis. 3rd declension fern.
Uvula, pl. uvulae, gen. uvulae. Uvula (lit. small grape, from uvn, pl.
uvae, grape). 1st declension fern.
Unit IX Latin and Greek Terminology
• Vagina, pl. vaginae, gen. vaginae. Vagina, sheath. 1st declension fern.
• Vaginitis, pl. vaginitides, gen. vaginitidis. Vaginitis. 3rd declension fern.
• Vagus, pl. vagi, gen. vagi. Vagus nerve. 2nd declension masc. (adj.: masc.
vagus, fern. vaga, neut. vagum. Roving, wandering).
• Valva, pl. valvae, gen. valvae. Leaflet. 1st declension fern.
• Valvula, pl. valvulae, gen. valvulae. Valve. 1st declension fern.
• Varix, pl. varices, gen. varicis. Varix, varicose vein. 3rd declension masc.
• Vas, pl. vasa, gen. vasis. Vessel. 3rd declension neut.
- Vas deferens, vasa recta, vasa vasorum.
• Vasculum, pl. vascula, gen. vasculi. Small vessel. 2nd declension neut.
• Vastus, pl. vasti, gen. vasti. Vast, huge. 2nd declension neut. (adj.: masc.
vastus, fern. vasta, neut. vasti).
- VaStus medialis/ intermedius/ lateralis m.
• Vasum, pl. vasa, gen. vasi. Vessel. 2nd declension neut.
• Velum, pl. veli, gen. veli. Covering, curtain (lit. sail). 2nd declension
• Vena, pl. venae, gen. venae. Vein. 1st declension fern.
- Vena cava, pl. venae cavae, gen. venae cavae (from masc. cavus, fern.
cava, neut. cavum, hollow).
• Ventriculus, pl. ventriculi, gen. ventriculi. Ventricle (lit. SiTl all belly).
2nd declension masc.
• Venula, pl. venulae, gen. venulae. Venule. 1st declension fern.
• Vermis, pl. vermes, gen. vermis. Worm. 3rd declension masc.
• Verruca, pl. verrucae, gen. verrucae. Wart. 1st declension fern.
• Vertebra, pl. vertebrae, gen. vertebrae. Vertebra. 1st declension fern.
• Vertex, pl. vertices, gen. verticis. Vertex (lit. peak, top). 3rd declension
• Vesica, pl. vesicae, gen. vesicae. Bladder. 1st declension fern.
• Vesicula, pl. vesiculae, gen. vesiculae. Vesicle (lit. lesser bladder). 1st declension fern.
• Vestibulum, pl. vestibula, gen. vestibuli. Entrance to a cavity. 2nd declension neut.
• Villus, pl. villi, gen. villi. Villus (shaggy hair). 2nd declension masc.
• Vinculum, pl. vincula, gen. vinculi. Band, band-like structure (lit. chain,
bond). 2nd declension neut.
• Virus, pl. Lat. viri, pl. Engl. viruses, gen. viri. Virus. 2nd declension
• Viscus, pl. viscera, gen. visceris. Viscus, internal organ. 3rd declension
• Vitiligo, pl. vitiligines, gen. vitiligis. Vitiligo. 3rd declension masc.
• Vomer, pl. vomeres, gen. vomeris. Vomer bone. 3rd declension masc.
• Vulva, pl. vulvae, gen. vulvae. Vulva. 1st declension fern.
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Unit X Acronyms and Abbreviations
“The patient went from the ER to the OR and then to the ICU.”
It is an irrefutable fact that doctors’ speech is full of abbreviations. Healthcare professionals in general and radiologists in particular use at least ten
abbreviations per minute (this is our own home-made statistic; please don’t
quote us). This high prevalence has led us to consider medical abbreviations
as a challenging pandemic.
There are several “types” of abbreviations, namely:
Straightforward abbreviations
Extra-nice abbreviations
Expanded-term abbreviations
Energy-saving abbreviations
Double-meaning abbreviations
Mind-blowing abbreviations
Let us begin with the nice ones; we call them the straightforward abbreviations because for each nice abbreviation in your own language there is a
nice English equivalent. No beating around the bush here. It’s just a matter
of changing letter order, identifying the abbreviations and learning them.
Let us give you a few examples so you can enjoy the simple things in life
. while you can!
Hormone replacement therapy
Left ventricle outflow tract
Atrial septal defect
Ventricular septal defect
Transesophageal echocardiography
Left anterior descending artery
Angiotensin converting enzyme
Unit X Acronyms and Abbreviations
There are other kinds of abbreviation: the extra-niCe ones. They are mostly
used for drugs or chemical substances whose name has three or four syllables too many. They are extra nice because they are usually the same in
many languages. Let’s see just an example:
CPK Creatine phosphokinase
In the next group, we have put together some examples of abbreviation5 that
are widely used in English but that are generally preferred in their expanded
form in other languages. Since language is an ever-changing creature, we are
sure that these terms will eventually be abbreviated in many languages but so
far you can hear them referred to mostly as expanded terms:
Non-small-cell lung cancer
Peripheral blood stem cell
There is another group which we call the energy-saving abbreviations.
These are abbreviations that many languages leave in the English original
and, of course, when expanding them the first letter of each word doesn’t
match the abbreviation. We call them energy-saving because it wouldn’t
have been so difficult to come up with a real “national” abbreviation for
that term. When looking for examples, we realized that most hormone
names are energy-saving abbreviations:
Follicle-stimulating hormone
Tumor necrosis factor
Pulmonary arterial wedge
There is yet another kind, which we call the double-meaning abbreviations.
This is when one abbreviation can refer to two different terms. The context
helps, of course, to discern the real meaning. However, it is worth keeping
an eye open for these because, if misinterpreted, these abbreviations might
get you into an embarrassing situation:
— Polymerase chain reaction
— Plasma clearance rate
— Pathological complete response
— Protein catabolic rate
— Human enteric virus
— Hepatitis E virus
— Pelvic inflammatory disease
— Prolapsed intervertebral disc
— Colony-stimulating factor
— Cerebrospinal fluid
The funniest abbreviations are those that become acronyms in which the
pronunciation resembles a word that has nothing to do with the abbreviation’s meaning. We call this group the mind-blowing abbreviations.
A cabbage in English is that nice vegetable known for its gasogenic
properties. However, when an English-speaking surgeon says “This patient
is a clear candidate for cabbage”, he/she isn’t talking about what the patient
should have for lunch, but rather the type of surgery he/she is suggesting
should be performed. Thus, cabbage is the colloquial way of referring to
CABtS (coronary artery bypass grafting).
If you happen to be eavesdropping in a corridor and you hear an oncologist saying “I think your patient needs a ChOp”, you walk on down the
corridor, wondering whether this new alternative therapy will consist of a
pork or a lamb chop. But then you quickly realize that the specialist you
were eavesdropping on was actually referring to a CHOP (a regimen of cyclophosphamide, hydroxydaunomycin, oncovin and prednisone, used in
cancer chemotherapy).
There are more abbreviations out there, and there are also more to
come. The medical profession is sure to keep us busy catching up with its
incursions into linguistic creation.
Regardless of the “type” of abbreviation you have before you, we will
give you three pieces of advice:
1. Identify the most common abbreviations.
2. Read the abbreviations in your lists.
3. Begin with abbreviation lists of your radiological subspecialty.
Read the abbreviations in your lists. Read the abbreviations in your lists in a
natural way. Bear in mind that to be able to identify written abbreviations
may not be enough. From this standpoint, there are three types of abbreviations:
1. Spelt abbreviations
2. Read abbreviations (acronyms)
3. Half-spelled/half-read abbreviations
Nobody would understand a spelt abbreviation if you read it and nobody
would understand a read abbreviation if you spelt it. Let us make clear
what we are trying to say with an example. LAM stands for lymphangiomyomatosis and must be read Ham. Nobody would understand you if instead of saying lam you spell L-A-M. Therefore, never spell a “read abbreviation” and never read a “spelt abbreviation”.
Most abbreviations are spelt abbreviations, and are usually those in
which the letter order makes them almost impossible to read. Think, for
example, of COPD (chronic obstructive pulmonary disease) and try to read
the abbreviation instead of spelling it. Never use the “expanded form”
(chronic obstructive pulmonary disease) of a classic abbreviation such as
this one because it would sound extraordinarily unnatural.
Unit X Acronyms and Abbreviations
Some abbreviations have become acronyms and therefore must be read
and not spelt. Their letter order allows us to read them. LAM belongs to
this group.
The third type is made up of abbreviations such as CPAP (continuous
positive airway pressure) which is pronounced something like C-pap. If
you spell out CPAP (C-P-A-P), nobody will understand you.
Review abbreviation lists on your specialty. Review as many abbreviation lists
on your specialty as you can and double-check them until you are familiar
with their meaning and pronunciation.
Although you should make your own abbreviation lists, we have created
several classified by specialty. To begin with, check whether your own specialty’s list is included; if not, start writing your own. Be patient ... this
task can last the rest of your professional life.
Abbreviation Lists
General List
Allergic bronchopulmonary aspergillosis
Angiotensin-converting enzyme
Antibodies to cardiolipin
Adrenocorticotropic hormone
Antidiuretic hormone
Autosomal dominant polycystic kidney disease
Atrial fibrillation
Alpha fetoprotein
American Joint Cancer Commission
Alanine aminotransferase
Acute myeloid leukemia
Antinuclear antibodies
Atrial premature complexes
Arterial pressure index
Amine precursor uptake and decarboxylation system
Acute respiratory distress syndrome
Acute renal failure
Ankylosing 5pondylitis
Aspartate aminotransferase
Acute tubular necrosis
Arginine vasopressin
Bronchoalveolar lavage
Basal cell carcinoma
Abbreviation Lists
Bacillus Calmette-Guérin
Bone marrow transplant
Bullous pemphigoid
Brazilian purpuric fever
Common bile duct
Crohn disease
Carcinoembryonic antigen
Cystic fibrosis
Chronic myeloid leukemia
Chronic myelomonocytic leukemia
Chronic obstructive pulmonary disease
Cicatricial pemphigoid
Chronic renal failure
Corticotropin-releasing hormone
Colony stimulating factor
Computed tomography
Cholera toxin
Cancer of unknown primary site
Coal workers’ pneumoconiosis
Chest X-ray
Ductal carcinoma in situ
Discoid lupus erythematosus
Disseminated gonococcal infection
Dermatitis herpetiformis
Diffuse idiopathic skeletal hyperostosis
Diastolic blood pressure
Dialysis-related amyloidosis
Digital rectal examination
Duodenal ulcer
Deep venous thrombosis
Epidermolysis bullosa acquisita
Epstein Barr virus
Endoscopic retrograde cholangiopancreatography
End-stage renal disease
Familial amyloid polyneuropathies
Forced expiratory volume in one second
Familial Mediterranean fever
Focal and segmental glomerulosclerosis
Follicle-stimulating hormone
Glomerular basement membrane
Germ cell tumor
Glomerular filtration rate
y-Glutamyltranspeptidase, y-glutamyltransferase
Unit X Acronyms and Abbreviations
Growth hormone
Growth hormone-releasing hormone
Gastrin inhibitory peptide
Gastric ulcer
Hepatitis B virus
Human chorionic gonadotropin
Hepatitis C virus
Human immunodeficiency virus-associated
Hypertrophic osteoarthropathy
Hypersensitivity pneumonitis
Human papilloma virus
Hormone replacement therapy
Hematopoietic stem cell
Hemolytic uremic syndrome
Inflammatory bowel disease
Irritable bowel syndrome
Interstitial lung disease
Immunoproliferative small intestinal disease
(Mediterranean lymphoma)
Idiopathic thrombocytopenic purpura
Juvenile nephronophthisis
Lupus anticoagulant
Left bundle branch block
Light chain deposition disease
Lactate dehydrogenase
Lower esophageal sphincter
Luteinizing hormone
Lymphoid interstitial pneumonitis
Mycobacterium av ium complex
Mucosa-associated lymphoid tissue
Medullary cystic disease
Minimal change disease
Mean corpuscular hemoglobin concentration
Mixed connective tissue disease
Mean corpuscular volume
Type 1 multiple endocrine neoplasia
Membranoproliferative glomerulopathies
Magnetic resonance
Magnetic resonance imaging
Nonsteroidal anti-inflammatory drugs
Non-ulcer dyspepsia
Oral cholecystography
Abbreviation Lists
Organic dust toxic syndrome
Obstructive sleep apnea
Primary alveolar hypoventilation
Polyarteritis nodosa
Pulmonary alveolar proteinosis
Primary biliary cirrhosis
Prophylactic cranial irradiation
Pneumocystis Carinii pneumonia
Physicians’ desk reference (vademecum)
Percutaneous endoscopic gastrostomy
Pemphigus foliaceus
Pemphigoid gestationis
Prolactin inhibitory factor
Progressive multifocal leukoencephalopathy
Peripheral primitive neuroectodermal tumor
Plasma renin activity
Prostate-specific antigen
Psoriatic arthritis
Percutaneous transhepatic cholangiography
Pulmonary thromboembolism
Parathyroid hormone
Pemphigus vulgaris
Rheumatoid arthritis
Right bundle branch block
Red blood cell
Rheumatoid factor
Rocky mountain spotted fever
Rapidly progressive glomerulonephritis
Rapidly progressive renal failure
Renal tubular acidosis
Residual volume
Renal vein thrombosis
Secondary biliary cirrhosis
Systolic blood pressure
Squamous cell carcinoma
Severe combined immunodeficiency
Subacute cutaneous lupus erythematosus
Serum iron
Syndrome of inappropriate secretion of antidiuretic
Systemic lupus erythematosus
Spontaneous bacterial peritonitis
Systemic sclerosis
Superior vena cava syndrome
Unit X Acronyms and Abbreviations
WDHA syndrome
Tran5bronchial biopsy
Transforming growth factor Q
Transferrin iron-binding capacity
Transjugular intrahepatic portosystemic shunt
Total lung capacity
Tumor necrosis factor
Thyrotropin-releasing hormone
Thyroid-stimulating hormone
Transtracheal aspiration
Thrombotic thrombocytopenic purpura
Ulcerative colitis
Video-assisted thoracic surgery
Vital capacity
Ventricular fibrillation
Vasoactive intestinal peptide
Ventricular premature complexes
White blood cell
Watery diarrhea, hypokalemia and achlorhydria
syndrome (Verner-Morrison)
Zollinger-Ellison syndrome
Lists by Specialty
Acromioclavicular joint
Anterior cruciate ligament
Anterior cervical space
Anorectal angle
Anterior tibial artery
Basle Nomina Anatomica
Common bile duct
Common femoral artery
Common hepatic artery
Common hepatic duct
Cranial nerve
Central nervous system
Carotid space
Deep cervical fascia
Deep layer of the deep cervical fascia
Distal radioulnar joint
Extensor carpi ulnaris
External elastic lamina
Abbreviation Lists
Gastroduodenal artery
Gastroesophageal junction
International anatomical nomenclature
Internal carotid artery
International Commision on Radiological Protection
Internal elastic lamina
Intrahepatic biliary ducts
Inferior mesenteric artery
Iliotibial band
Inferior vena cava
Jugular vein
Left atrium
Left atrial appendage
Left anterior descending coronary artery
Lateral collateral ligament
Left circumflex coronary artery
Lower esophageal sphincter
Left gastric artery
Left hepatic artery
Left hepatic duct
Left hepatic vein
Left internal mammary artery
Left lower lobe (of lung)
Left lower quadrant (of abdomen)
Left portal vein
Lateral ulnar collateral ligament
Left upper lobe (of lung)
Left upper quadrant (of abdomen)
Left ventricle
Left ventricular outflow tract
Medial collateral ligament
Middle hepatic artery
Middle layer of the deep cervical fascia
Masticator space
Nomina anatomica
Obtuse marginal branch
Posterior cruciate ligament
Posterior cervical space
Posterior descending anterior coronary artery, patent
ductus arteriosus
Pancreaticoduodenal vein
Proper hepatic artery
Posteroinferior cerebellar artery
Unit X Acronyms and Abbreviations
Pharyngeal mucosal space
Parotid space
Posterior tibial artery
Portal vein
Right atrium
Reticular activating system
Radial collateral ligament
Right descending pulmonary artery
Right hepatic artery
Right hepatic duct
Right hepatic vein
Right internal mammary artery
Right lower lobe (of lung)
Right lower quadrant (of abdomen)
Retropharyngeal space
Right portal vein
Right upper lobe (of lung)
Right upper quadrant (of abdomen)
Right ventricle
Right ventricular outflow tract
Superficial cervical fascia
Sternocleidomastoid muscle
Subclavian vein
Superficial femoral artery
Sublingual space
Superior mesenteric artery
Smooth muscle cell
Submandibular space
Superior mesenteric vein
Superior vena cava
Triangular fibrocartilage complex
Temporomandibular joint
Ulnar collateral ligament
Upper esophageal sphincter
Ureteropelvic junction
Ureterovesical junction
Visceral space
Abbreviation Lists
Clinical History
AC, a.c.
ad lib.
BC, BLCO, cbc
BID, b.i.d.
Ch. D.
Airway, breathing, circulation, defibrillate in cardiopulmonary resuscitation
Above symptoms
Ante cibum (before a meal)
Ad libitum (as desired)
Adverse drug reaction
Auris uterque (each ear)
Alert, responsive to verbal stimuli, responsive to painful stimuli, and unresponsive (assessment of mental
Alcohol withdrawal symptoms
(Complete) blood count
Bis in die (twice a day)
Biochemistry profile
Blood pressure
BUN and creatinine
Blood urea nitrogen/creatinine
Chief complaint
Calculated creatinine clearance
Chirugiae doctor, surgery doctor
Cibus (food)
Cortically originating extrapyramidal symptoms
Complete physical examination
Creatinine clearance
Current vital signs
Dexter (right)
Differential diagnosis
Diastolic murmur
Do not resuscitate
Dead on arrival
Digital rectal examination
Deep tendon reflex
Emergency admission
Emergency admission unit
Extrapyramidal motor symptoms
Erythrocyte sedimentation rate
First-catch urine sediment
Fluid, electrolytes, and nutrition
Family history
Family history positive/negative
Family history of alcoholism/heavy drinking
Unit X Acronyms and Abbreviations
IV, i.v.
PE, Pex, Px, PHEX
PO, P.O.
Family hi5tory of cancer
Family history of essential hypertension
Family history of mental illness
Family history symptom free
Family history of vascular disease
Gastroesophageal reflux symptoms
Gastrointestinal symptoms
General practitioner
History and physical examination
Heat, absence of use, redness, pain, pus, swelling
Irritable bowel symptoms
Illness-related symptoms
Left upper quadrant (of abdomen)
Lower urinary tract symptoms
Medicinae doctor
Mutiple occurrence of unexplained symptoms
Nil by mouth (nothing by mouth, U.K.)
Negative family history
No inflammatory signs
Non-specific symptoms
No heart failure symptoms
No symptoms
Nil per os (nothing by mouth, U.S.)
Neurologist’s physical examination
No signs of acute disease
No signs of infection/inflammation
Neurological vital signs
No visual symptoms
Oculus dexter (right eye), overdose
On physical examination
Oculus sinister (left eye)
Post cibum (after meals)
Pro re nata (according to circumstances, may require)
Per vaginam
Present complaint
Patient-controlled analgesia
Persistent cold-like symptoms
Physical examination
Problem, etiology, signs and symptoms
Positive family history
Past history
Past history of illness
Premenstrual symptoms
Per os (by mouth, orally)
Problem-oriented medical record
Abbreviation Lists
si op. sit,
VS, vs
Peer physical examination5
Parts per million
Progressive-resistance exercise
Physical therapy/therapist
Quaque secunda hora (every two hours)
Quaque tertia hora (every three hours)
Quaque die (every day)
Quaque hora (every hour)
Quater in die (four times daily)
Quantum vis (as much as desired)
Red blood count
Recommended daily allowance
Respiratory symptoms
Right lower lobe (of lung)
Right lower quadrant (of abdomen)
Right middle lobe (of lung)
Rheumatic-musculoskeletal symptoms/diseases
Review of symptoms
Right upper lobe (of lung)
Right upper quadrant (of abdomen)
Prescribe, prescription drug
Signs and symptoms
Symptoms of acute stress reaction
si opus sit (if necessary)
Systolic murmur
Subjective, objective, assessment, and plan
(used in problem-oriented records)
Signs and symptoms of heart failure
Stained urinary sediment
Ter in die (three times daily)
Thyroid function test
(There is) no family history of ...
Total parenteral nutrition
Totally reversible ischemic neurological symptoms
(Total) white blood count
Urea and electrolytes
Urinary excretion of electrolytes
Upper gastrointestinal symptoms
Urogenital symptoms
Urine electrolytes
Vocal resonance
Vital signs
Vital signs absent
Unit X Acronyms and Abbreviations
Vital signs normal
Work-related symptoms
the ffospitaf
Coronary care unit
Critical care unit
Intermediate care facility
Intensive care unit
Emergency care unit
Emergency medical service
Emergency room
Operating theater/theatre
Computed tomography (Ef), Image Reconstruction and Reformation
Computed axial tomography
Contrast enhanced CT
Curved planar reformation
Computed tomography
CT angiography, CT arteriography
CT during arterial portography
CT cholangiography
CT dose index
CT hepatic arteriography
CT myelography
CT perfusion imaging
Continuous volume scanning
Delay CT myelography
Dual-energy quantitative CT
Electron beam CT
Electron beam tomography
Field of view
Full width at half maximum
Full width at tenth area
High-resolution CT
Hounsfield units
Linear interpolation
Metrizamide CT myelography
Maximum intensity projection
mlP, minIP
Minimum intensity projection
Multislice linear interpolation
Multiplanar reformation
Mean transit time
Abbreviation Lists
Noise-reduced maximum intensity projection
Quantitative CT
Region of interest
Slice collimation
Single-energy CT
Scan field of view
Signal-to-noise ratio
Shaded surface display
Section sensitiviy profile
Step volume scanning (EBCT)
Table feed
Ultrafast CT
Volume of interest
Volume rendering technique
Conventional Radiology
At Wt, AW
csc, cc, ccc
Abduction and external rotation
American College of Radiology
As low as reasonably achievable (radiation dosages)
American Society of Neuroradiology
American Society of Spine Radiology
Atomic Weight
Barium enema
Barium swallow
Cholecystectomy and operative cholangiogram
Conventional dacryocystography
Curved planar reformation
Cathode ray tube
Cholecystography or cholecystogram
Chest X-ray
Double contrast
Double-contrast shoulder arthrography
Digital fluorocholangiogram
Digital imaging and communications in medicine
Dose—length product
Digital subtraction arthrography
Field of view
Full width at half maximum
Full width at tenth area
Unit X Acronyms and Abbreviations
High osmolar contrast agent
International Commision on Radiological Protection
Intraoperative cholangiogram
Intravenous cholangiogram
Intravenous pyelogram
Intravenous urogram
(plain abdominal radiography)
Left anterior oblique position
Late arterial phase
Lumbar metrizamide myelography
Low osmolar contrast medium
Left posterior oblique position
Look-up table
Micturating cystography
Micturating cystourethrogram
Noise-reduced maximum intensity projection
Oral cholecystography
Oral cholangiogram
Picture archive and communication system
Plain film metrizamide myelography
Parotid sialography
Portal venous phase
Right anterior oblique
Retrograde cystogram
Retrograde pyelogram, retrograde pyelography
Retrograde urethrogram, retrograde urethrography
Region of interest
Right posterior oblique
Retrograde urogram
Retrograde ureteropyelography, retrograde pyelogram
Signal to noise ratio
Small-bowel follow-through examination
Single contrast
Single-contrast graded-compression technique
(GI radiology)
Society of Cardiovascular and Interventional
Scan field of view
Space-occupying lesion
Shaded surface display
Abbreviation Lists
Interventional Radiology
T-tube cholangiogram
Time to peak
Upper gastrointestinal series
Voiding cystography
Voiding cystourethrogram, voiding cystourethrography
Volume of interest
Volume rendering
Volume rendering technique
Water-soluble myelography
Bird’s nest filter
Central venous access
Digital subtraction angiography
Early arterial phase
Endoscopic retrograde cholangiography
French (unit of a scale for denoting size of catheters)
Fine-needle aspiration cytology
Full width at half maximum
Hemodynamic access fistula
Intraaortic counterpulsation balloon pump
Late arterial phase
Lumbar puncture
Percutaneous cholecystostomy
Percutaneous drainage
Percutaneous nephrostomy
Pulmonary capillary wedge pressure
Percutaneous endoscopic gastrostomy
Percutaneous ethanol injection
Percutaneous fluoroscopic gastrostomy
Peripherally inserted central catheter
Percutaneous transluminal angioplasty
Percutaneous transhepatic biliary drainage
Percutaneous transhepatic cholangiography
Percutaneous transhepatic cholangiography
Portal venous phase, percutaneous vertebroplasty
Recombinant tissue plasminogen activator
Standards of Practice Guidelines on Angioplasty
Transcatheter arterial chemoembolization
Transjugular intrahepatic portosystemic shunt
Transthoracic needle biopsy
Unit X Acronyms and Abbreviations
Tissue plasminogen activator
Time to peak
Vena-Tech (vena cava filter)
i/Iognetic Resonance Imaging (l/lfiIl)
Chemical shift selective pulses
Contrast medium-enhanced MRI
Contrast to noise ratio
Centrally ordered phase encoding
Chemical shift imaging (magnetic resonance
spectroscopy method)
Cardiovascular magnetic resonance
Dynamic nuclear magnetic resonance
Diethylene triamine pentaacetic acid (a binding
substance for both Gd and 99m-Tc)
Diffusion-weighted image
Electron MRI
Echoplanar imaging
Echoplanar magnetic resonance
Echoplanar magnetic resonance spectroscopic
Endorectal surface coil MRI
Electron spin resonance
Echo train length
Fourier-acquired steady-state technique
Flow compensation
Free induction decay
Fast imaging with steady-state precession
Fast low-angle shot
Functional MRI
Functional MRI of the brain
Fast saturation
Fast spin echo
Fourier transform
Fourier transform nuclear magnetic resonance
Gadolinium-diethylenetriamine penta-acetic acid
Gadolinium-enhanced magnetic resonance arteriography
Gradient echo
Gadolinium-enhanced magnetic resonance angiography
Gradient-recalled acquisition in steady-state
Gradient-recalled echo, gradient echo
Gradient rephasing motion
Half Fourier acquisition single-shot turbo spin echo
Abbreviation Lists
Interventional MRI
Inversion recovery
International Society for Magnetic Resonance
in Medicne
Magic angle spinning nuclear magnetic resonance
Multiple overlapping thin-slab acquisition
Multiplanar two-dimensional gradient echo
Magnetic resonance angiography
Magnetic resonance arthrography
Magnetic resonance cholangiopancreatography
Magnetic resonance elastography, magnetic resonance
Magnetic resonance imaging
Magnetic resonance myelography
Magnetic resonance spectroscopy
Magnetic resonance urography
Magnetic resonance venography/venogram
Modulation transfer function
Magnetization transfer pulse
N-Acetyl aspartate (MR spectroscopy)
Number of acquisitions
Number of excitations
Nuclear MRI
Phase contrast
Proton magnetic resonance
Perfusion-weighted imaging
Respiratory-ordered phase encoding
Specific ab5orption rate
Spin echo
Sensitivity encoding for MRI
Interslice spacing
Slice thickness
Simultaneous acquisition of spatial harmonics
Society of Magnetic Resonance Imaging
Spoiled gradient recalled acquisition in steady state,
spoiled gradient-recalled echo
Superparamagnetic iron oxide (particles)
Spectral presaturation by inversion recovery
Steady-state free precession
Solid-state nuclear magnetic resonance
Stimulated-echo acquisition mode
Short-tau inversion recovery, short Tl inversion
Unit X Acronyms and Abbreviations
fluclear Medicine
Tl-weighted image
T2-weighted image
Time to echo (echo time)
Inversion time
Time of flight
Time of repetition (repetition time)
Turbo spin echo
Ultrasmall superparamagnetic particles
Velocity-encoded cine MRI
Axillary lymphoscintigraphy
Computer processed dynamic scintigraphy
Cerebral scintigraphy
Direct isotope cystography
99m-Tc-Dimercaptosuccinic acid scintigraphy
Dynamic perfusory lung scintigraphy
Direct radionuclide cystography
Direct radionuclide voiding cystography
Dipyridamole-Thallium myocardial scintigraphy
Exercise myocardial perfusion scintigraphy
Hepatobiliary functional scintigraphy
Hepatobiliary scintigraphy with dimethyliminodiacetic acid
I-123-Isopropy1iodoamphetamine (radiolabeled agent
for brain perfusion SPECT)
Indirect radionuclide cystography
Isotope-voiding cystourethrogram
Myocardial perfusion scintigraphy
Positron emission tomography
Regional cerebral blood flow
Radionuclide voiding cystography
Se5talTlibi scan
Single photon emission computed tomography
Somatostatin receptor scintigraphy
Sestamibi scintimammography
Technetium-99m bicisate ethyl cysteinate dimer
(radiolabeled agent for brain perfusion SPECT)
Technetium-99m-hexamethyl propylamine oxime
(radiolabeled agent for Brain Perfusion SPECT)
Tc—99m-labeled RBCs Red blood cell scan (Meckel’s scan)
Thalium myocardial scintigraphy
Abbreviation Lists
V/Q scanning
WBC scans
CW Doppler
Three-phase dynamic bone scintigraphy
Ventilation-perfusion scintigraphy
White blood cell scans
Whole body scintigraphy
White cell scintigraphy
Three-dimensional ultrasound
Acoustic densitometry (ultrasound)
Bi-parietal diameter (ultrasound measurement
of the head of a fetus)
Complete compression ultrasound
Color Doppler imaging
Contrast-enhanced ultrasound
Crown rump length (ultrasound fetal measurement)
Continuous wave Doppler
Doppler power velocity time integral
Dynamic range
End diastolic velocity
Extended field of view
European Journal of Ultrasound
Echolucent band
Endorectal ultrasonography, endorectal ultrasound
Echostrong band
Endovascular ultrasonography, endoscopic ultrasound
Endovaginal sonography
Endovaginal ultrasound
International Society of Ultrasound in Obstetrics and
Intravascular ultrasound
Power Doppler imaging
Pulsatility index
Pulse inversion mode
Prenatal ultrasonography
Pulse repetition frequency
Peak systolic velocity
Pulsed—wave Doppler
Quantitative ultrasound index (bone density)
Quantitative ultrasound
Resistivity index
Real-time ultrasound
Society for Vascular Ultrasound
Transabdominal ultrasonography
Transesophageal echocardiography
Time-gain compensation
Unit X Acronyms and Abbreviations
Time harmonic imaging
Transrectal ultrasound
Transurethral ultrasound-guided laser-induced
Transabdominal ultrasound
Ultrasound, ultrasonography
Ultrasound-guided aspiration biopsy
Ultrasound multi-frame (images)
Voiding urosonography, voiding urethrosonography
Exercises: Common Sentences Containing Abbreviations
This section presents common sentences containing abbreviations, followed
by the definitions of the abbreviations used.
• A 40-year-old man visited our hospital, and was diagnosed as having
Felty’s syndrome because of splenomegaly and pancytopenia as well as
definite RA.
• MCV, MCHC, LDH, ANA and RF values are normal.
• The platelet and WBC counts exceeded their normal ranges. He was diagnosed as suffering from ... (ITP, CMML, AML, CML). Two months
after, he received a BMT.
• Foreign bodies display a variable signal intensity on both Tl- and T2weighted images. MR shows an inflammatory response while CT can
show the retained foreign body. US evaluation could be useful in selected patients.
• COPD is a risk factor in the development of TB.
• Cholera can be diagnosed by the presence of CTX in stools.
• A 16-year-old female suffering from fever, chills, rash and presenting
multiple nodular opacities in CXR was diagnosed as having ... (RMSF,
• An ECG was obtained, and showed ... (RBBB, LBBB, APCs, VPCs, AF,
• He is actually under treatment with ACEI. Ten years ago he was treated
with PTCA because of the three AMI he had suffered.
• RA and SSc are more common in females.
• PCP and PML are two of the complications that can be suffered by AIDS
Abbreviation Lists
• Cutaneous manifestations of SLE can be divided into SCLE (acute) and
DLE (chronic).
• The key to the diagnosis of septic arthritis is joint aspiration. Joint fluid
is opaque and has a WBC count greater than 100,000.
• Clinical signs of skeletal metastases include hypercalcemia and the syndrome known as HPO.
• Prolonged morning stiffness helps to distinguish a truly inflammatory
arthritis such as RA from non-inflammatory arthritides such as OA.
• The typical attack of acute gouty arthritis is a painful monoarthritis,
most often in the first MTP joint (podagra).
• Scaphoid fractures exhibit a high rate of non-union and AVN.
• Water is arbitrarily assigned a value of 0 HU.
• MRI is the imaging modality of choice for the CNS.
• The aorta is normally visible on PA and lateral chest radiographs.
• Generally, a PT of below 15 seconds, a PTT within 1.2 times control and
a platelet count greater than 75,000/ml will be acceptable.
• TIPS is a relatively new technique for the treatment of patients with portal hypertension.
• To rule out the presence of DVT, a lower extremity ultrasound examination should be performed.
• Approximately 1% of cardiac muscle cells, including those in the SA and
AV nodes, are autorhythmic.
• In the chronic form of mitral regurgitation, clinical monitoring focuses
on the evaluation of left ventricular function, with treatment of CHF.
• The RCA supplies the right ventricle and the AV node.
• The LCA divides into the anterior descending and circumflex arteries.
• In the ARDS an increase in capillary permeability occurs.
• SOB can usually be attributed to one of two fundamental categories of
disease, cardiac or pulmonary.
• In patients with documented DVT or PE in whom anticoagulation is
contraindicated, percutaneous placement of an IVC filter in the angiography suite may be warranted.
• The azygous vein provides venous drainage into the SVC.
• NHL carries a less-favorable prognosis than Hodgkin’s disease.
• There is a strong association between thymoma and MG.
• Neurofibromas and schwannomas are more common in patients with
• KS remains the most common malignancy in HIV disease and constitutes an AIDS-defining illness.
• LIP is an AIDS-defining illness in children.
• One of the classic differential diagnoses in radiology is that of the SPN.
• The SMA supplies the bowel between the duodenojejunal junction and
the splenic flexure of the colon.
• CT scanning has replaced DPL for detecting and evaluating free fluid
within the abdominal cavity.
• The pelvis joins the ureter at the UPJ, a common site of obstruction.
Unit X Acronyms and Abbreviations
• The higher incidence of UTIs in young women is attributed to the relatively short female urethra.
• When an ACE inhibitor is administered, glomerular filtration is reduced.
• Intrinsic renal causes of acute renal failure include ATN and acute glomerulonephritis.
• A clue to the prerenal nature of the failure is contained in the ratio of
serum BUN to creatinine.
• The standard screening mammogram includes two views of each breast:
the CC view and the MLO view.
• Hydrocephalus is called obstructive when there is a blockage of normal
flow of CSF.
• Fetal growth is assessed by measurement of abdominal circumference,
which is important in detecting IUGR.
• The transitional zone represents the site of BPH.
• Strokes are sometimes preceded clinically by so-called TIAs.
• The most common location of stroke is in the MCA distribution.
• ACA occlusion may cause contralateral foot and leg weakness.
• A small infarction in some portions of the PCA territory may have catastrophic consequences.
• HMD is the most common cause of neonatal respiratory distress.
• An important complication of long-term ventilatory support is BPD.
• TTN occurs when there is inadequate or delayed clearance of the fluid at
birth, resulting in a “wet lung”.
• EA and TEF both represent anomalies in the development of the primitive foregut.
• NEC occurs primarily in premature neonates exposed to hypoxic stress.
• DDH is suspected clinically in newborns with a breech presentation.
• PVL is the result of prenatal or neonatal hypoxic-ischemic insult.
• An AVM is a congenital lesion resulting from persistent fetal capillaries.
Anterior cerebral artery
Angiotensin-converting enzyme
Angiotensin-converting enzyme inhibitor
Atrial fibrillation
Acquired immunodeficiency syndrome
Acute myocardial infarction
Acute myeloid leukemia
Antinuclear antibodies
Atrial premature complexes
Acute respiratory distress syndrome
Acute tubular necrosis
Arteriovenous malformation
Avascular necrosis
Abbreviation Lists
Bone marrow transplantation
Bronchopulmonary dysplasia
Brazilian purpuric fever
Bening prostatic hyperplasia
Blood-urea nitrogen
Congestive heart failure
Chronic myeloid leukemia
Chronic myelomonocytic leukemia
Central Nervous System
Chronic obstructive pulmonary disease
Cerebrospinal fluid
Computed tomography
Cholera toxin
Chest X-ray
Developmental dysplasia of the hip
Disseminated gonococcal infection
Discoid lupus erythematosus
Diagnostic peritoneal lavage
Deep venous thrombosis
Esophageal atresia
Human immunodeficiency virus
Hyaline membrane disease
Hypertrophic pulmonary osteoarthropaty
Hounsfield units
Idiopathic thrombocytopenic purpura
Intrauterine growth retardation
Inferior vena cava
Kaposi’s sarcoma
Left bundle branch block
Left coronary artery
Lactate dehydrogenase
Lymphocytic interstitial pneumonitis
Middle cerebral artery
Mean corpuscular hemoglobin concentration
Mean corpuscular volume
Myasthenia gravis
Mediolateral oblique
Magnetic resonance
Magnetic resonance imaging
Necrotizing enterocolitis
Neurofibromatosis type 1
Non-Hodgkin’s lymphoma
Unit X Acronyms and Abbreviations
Posterior cerebral artery
Pneumoc ystis carinii pneumonia
Pulmonary embolism
Progressive multifocal leukoencephalopathy
Prothrombin time
Percutaneous transluminal coronary angioplasty
Partial thromboplastin time
Periventricular leukomalacia
Rheumatoid arthritis
Right bundle branch block
Right coronary artery
Rheumatoid factor
Rocky mountain spotted fever
Subacute cutaneous lupus erythematosus
Systemic lupus erythematosus
Superior mesenteric artery
Shortness of breath
Solitary pulmonary nodule
Systemic sclerosis
Superior vena cava
Tracheoesophageal fistula
Transient ischemic attack
Transjugular intrahepatic portosystemic shunting
Transient tachypnea of the newborn
Ureteropelvic junction
Urinary tract infection
Ventricular fibrillation
Ventricular premature complexes
White blood cell
Abbreviation Lists
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Unit XI Describing a Lesion
Describing Anatomical Relationships
The description of the anatomical relationships of radiological findings is a
problem for radiologists even in their own native tongues. To be able to
talk properly on anatomical relationships you have, firstly, to have a sound
knowledge of the anatomical structures and, secondly, to know certain anatomical expressions and phrasal verbs usually forgotten long time ago because many years have passed since we studied Anatomy at Medical
• Lesions can be medial to the medial collateral ligament, cephalad to the
atriocaval junction, Caudal to the cecum, lateral to the tail of the pancreas ...
To be cephalad/caudal/lateral to or to be in relation with are some of the
indispensable phrasal verbs in Anatomy.
Let us think about this short anatomical paragraph:
• The scaphoid is the largest bone of the first carpal row. It is situated at
the superior and external part of the carpus, its direction being from
above downwards, outwards, and forwards. Its superior surface is convex, smooth, of triangular shape, and articulates with the lower end of
the radius.
Anatomical literature is tremendously cumbersome. We, as radiologists, do
not need to be so precise with regard to anatomical details, but we do need
to be as precise as possible regarding the anatomical relationships of the
radiological findings described in our reports.
Let us think now about this short radiological paragraph and notice how
many anatomical words and collocations are used:
• Adenoma with ipsilateral stalk movement. There is a microadenoma
present on the left side of the gland extending inferiorly and laterally.
This case is unusual in that the stalk is displaced toward the side of the
Unit XI Describing a Lesion
Anatomy and Radiology are intrinsically linked in radiological descriptions
since we cannot describe a pituitary gland adenoma without talking about
the pituitary gland itself, the stalk, the sella, the carotid arteries, the optic
chiasm, the cavernous sinus ...
We can occasionally find difficulties with the spelling of some anatomical structures — was it gray mater or gray matter, was it dura mater or dura
matter? (gray matter and dura mater) — or with the pronunciation of some
terms — was “hippo” in hippocampus pronounced as “hypo” in hypothalamus? (No) — but, generally speaking, most radioanatomical difficulties are
found in collocations and phrasal verbs such as “to give off”:
• Previous to its division into the gastroepiploica dextra and the pancreaticoduodenalis, the gastroduodenalis artery gives off two or three small
inferior pyloric branches to the pyloric end of the stomach and pancreas.
Let us analyze the following two-line sentence of anatomical English extracted without alteration from a musculoskeletal radiology article:
• The elbow is a synovial hinge joint between the trochlea and the capitellum, articulating with the trochleae notch of the ulna and the radial
More than half the words of the sentence come from Latin/Greek.
There are:
• One anatomical prepositional verb:
— articulate will
• Three anatomical concepts containing more than one word:
— synovial hinge joint
— trochlear notch
— radial head
• Two Anglo-Saxon anatomical nouns:
— elbow
— joint
• Three Latin/Greek nouns:
— trochlea
— capitellum
— ulna
• Three Latin/Greek adjectives:
— synovial
— trochlear
— radial
Describing Anatomical Relationships
Imagine an English-speaking lay person in radiology trying to understand
the sentence. The result would be something like:
• The elbow is a ... hinge joint between the ... and the ..., articulating
with the ... notch of the ... and the ... head.
If you cannot also pronounce properly, what will be understood of your
message will be something not too different from:
• The elbow is a ?? hinge joint between the ?? and the ??, articulating with
the ?? notch of the ?? and the ?? head.
It is quite obvious that this sentence, without filling in the blanks, has no
sense at all.
Although the need for a certain knowledge of Latin/Greek is, in principle, good news for health-care professionals from idiomatically Latin/Greek
countries and bad news for those with native tongues that do not come
from Latin/Greek, paradoxically many Latin doctors find great difficulty in
pronouncing Latin/Greek terms in English, and for them Latin becomes an
enemy instead of an ally. It is in the pronunciation of Latin terms where I
can identify a colleague of my country as a Spaniard, although he/she
speaks otherwise perfect English because it is very difficult to pronounce
in English words as usual in our native tongue as edema or lipoma. I have
noticed that sometimes Asian doctors, whose native tongues do not come
from Latin/Greek, make fewer mistakes pronouncing Latin/Greek terms in
English than their colleagues whose native languages have a great deal of
Latin/Greek etymology.
• Gross anatomy specimen of the anterior aspect of the elbow joint.
— Gross anatomy refers to macroscopic anatomy as opposed to the terms
microscopiC and radiological anatomy.
• The lateral aspect of the trochlea.
— Although the lateral trochlea is colloquially acceptable and commonly
used, the use of Infernf aspecf is more appropriate as there is only one
trochlea in the elbow.
• The medial aspect of the olecranon
— Similarly, the use of medial aspect is better than medial olecranon as
there is only one olecranon in the elbow.
• The capsule is attached to the humeral head
— The phrasal verb is “to be attached to”. To be attached at is not acceptable.
• The triangular ulnar collateral ligament of the elboW COllSlStS Of three
strong bands.
— To COnSiSt of is commonly used in anatomy to describe parts of a certain structure.
Unit XI Describing a Lesion
• The posterior band extends from the medial epicondyle to the medial aspeCt of the olecranon.
— To extend from ... to is one of the most common phrasal verbs in anatomical English.
• The medial epicondyle is the last to fuse.
— Medial epicondyle is a funny term since the prefix “epi” means above
and the “medial epicondyle” is above the trochlea so, why don’t name
it “epitrochlea” as in some romance languages?
• Pronation and supination take place at the proximal and distal radioulnar joints.
— To pronate and to supinate are typical anatomical verbs (pronation
and supination are substantives) that describe upper limb movements.
• The annular ligament is the key structure of the proximal radioulnar
joint encircling the radial head and neck without radial attachment.
— £RCircling an anatomical structure means to surround it without
being attached to it.
• The conjoined insertion of the triceps muscle demonstrates low signal
intensity at its attachment to the posterosuperior surface of the olecranon.
— Posterosuperior, posteroinferior, posterolateral are preferred to superoposterior, inferoposterior, and lateroposterior.
— Anterosuperior, anteroinferior, anterolateral are preferred to superoanterior, inferoanterior, and lateroanterior.
• The triceps muscle and tendon are located posterior to.
— To be posterior (anterior, lateral, caudal, cephalad, proximal, and disfue) fo is one of the most common anatomical/radiological phrasal
verbs. Posterior (anterior, lateral, caudal, cephalad, proximal, and distal) at is not acceptable.
Common Expressions in Vascular Anatomy
The pulmonary artery arises from the right ventricle.
The aorta conveys the oxygenated blood to every part of the body.
The aorta commences at the upper part of the left ventricle.
The arch of the aorta extends from the origin of the vessel to the lower
border of the body of the third dorsal vertebra.
The artery desCribes a curve, the convexity of which is directed upwards
and to the right side.
The ascending part of the aorta is about two inches in length.
It passes obliquely upwards in the direction of the heart axis.
The right coronary artery sends a large branch along the thin margin of
the right ventricle to the apex.
Describing Radiological Findings: Word Order
• The left coronary artery arises immediately above the free edge of the
left semilunar valve.
• The left coronary artery divides into two branches.
• The left coronary artery supplies the left auricle, both ventricles ...
• The innominate artery is the largest branch given off from the arch of
the aorta.
• The left common carotid lies on the trachea, esophagus, and thoracic
• The external carotid artery gives off eight branches which may be divided in four sets.
• The lingual artery runs obliquely upwards and inwards to the hyoid
(Anatomical) Relations
• In front
• Behind
On the right side
On the left side
Internally (medially)
Externally (laterally)
The ascending part of the arch is covered at its commencement by the
trunk of the pulmonary artery and the right auricular appendage, and
higher up, is separated from the sternum by the pericardium.
• On the right side, the ascending part of the aorta is in relation with the
superior vena cava and right auricle.
Describing Radiological Findings: Word Order
Lesions have shape, borders, density, signal intensity, echogenicity, size, aggressive or non-aggressive aspect, and many other features.
How should we describe lesions, taking into account that we must use
many adjectives?
Let us review these radiological descriptions:
• This sagittal image shows an ovoid hyperintense mass directly anterior
to the infundibulum.
• A lateral radiograph shows a sclerotic, bubbly lesion in the anterior tibial shaft.
• Tl-weighted axial images demonstrate a well-circumscribed low signal
intensity tumor with intact overlying cortex.
Unit XI Describing a Lesion
In most radiological sentences we use fact adjectives (size, length),
although sometimes we include opinion adjectives such as “aggressive”
based on certain radiological features.
As a general rule opinion adjectives go before fact adjectives.
When several fact adjectives coexist in a sentence we put them in the
following order:
1. Size/length
2. Shape/width
3. Age (generally not applicable; sometimes used in mentioning a previously described lesion)
4. Color (signal intensity, echogenicity, radiological density ...)
5. Material (bone, muscle, fat ...)
• A 5-cm (1), rounded (2), hyperintense on T2WI (4) fatty (5) lesion was
found in the left lobe of the liver.
Describing Focal Lesions
It is far from our intention to offer a comprehensive set of checklists to be
followed when reporting in English. Our only, and humble, goal is to provide you with a few useful idiomatic tools that can help you in your first
reports in English.
From a radiological point of view these terms are easy and almost every
radiologist has known them for many years. But to have them compiled in
a couple of pages will save you time and allow you to concentrate on what
is really important: the radiological findings themselves.
Since describing focal lesions in a radiological report can be troublesome for a non-native radiologist because of the scarcity of idiomatic resources, to count on an established description pattern is paramount.
These are some aspects you must not forget when describing a focal lesion. This is a standard checklist that can be u5ed for any lesion, although
some points are specific depending on the organ in which the lesion is
1. Solitary/single or multiple: If multiple, the pattern of distribution may
be reported (diffuse, segmental, lobar ...).
2. Size (large, small): Describe the size in millimeters. If multiple, you may
mention the largest one and the smallest one.
3. Shape (round, oval, lobulated, irregular).
4. Contour (smooth, irregular) and delimitation from the adjacent parenchyma (well-delimited/defined, poorly/ill delimited/defined).
5. Location: Describing the location of focal lesions depends on the organ
where they are sited.
Describing Focal Lesions
• Liver: right hepatic lobe (5egments V, VI, VII, VIII), left hepatic lobe
(segments II, III, IVA, IVB), Caudate lobe (segment I). Another way of
describing where focal lesions are sited is: anterior/posterior aspect of
the RHL, LHL, and dome of the liver.
• Pancreas: the location can be divided into head, uncinate process,
body and tail of the pancreas.
• Kidney: we refer to upper, mid or lower portions of the kidney. Upper
pole or lower pole can also be used. The use of mid-pole is somewhat
contradictory since poles mean extremes, but nonetheless “mid-pole”
is extensively used.
• Lung: in the lung we locate the lesion according to the lobe (RUL,
RLL, ML, LUL, LLL) and sometimes to the segment (the segments
can be designated either anatomically or by numbers. There are two
classical numerical classifications, the radiological and that of thoracic
surgeons which basically differ in upper lobe segments 2 and 3). A
few small details must be borne in mind when reporting lung lesions:
— Don’t forget that the expression right middle lobe is redundant
since there is no left middle lobe since the lingula belongs to the
left upper lobe.
— Don’t forget that segments IV and V belong to the middle lobe in the
right lung and the lingula to the left lobe, but segment IV is be- side
segment V in the middle lobe and above segment V in the lin- gula.
— Don’t forget that segment VII (anterior, medial, and basal) does not
exist as such in the left lung (some authors talk about segment VII—
• CNS: intracranial lesions can be either intraaxial or extraaxial. Intraaxial: cerebrum (frontal, temporal, parietal, and occipital lobes,
and corpus callosum), brain stem, and cerebellum. Extraaxial: dura
mater, arachnoid, or pia mater.
• Spine lesions can be divided into intradural intramedullary, intradural
extramedullary and extradural.
6. Density:
• Homogeneous/heterogeneous
• Low/high density/intensity
• Cystic/solid/complex (US)
• Search for the presence of other different densities within the lesion:
calcifications, fat, blood, necrosis, capsule, septa, scar.
7. Enhancement (enhancing lesion, non-enhancing lesion) and pattern of
• Evaluation in:
— Arterial phase/portal venous phase/equilibrium phase/delayed
phase (liver).
— Arterial phase/corticomedullary phase/nephrographic phase/excretory phase (kidney). Plus, delayed phase if bladder needs to be
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Unit XII Standard Normal Reports
Standard Reports
The standard radiological report is made up of the following sections:
In the following sections we present a selection of standard reports. Read
them aloud and write them down and you will immediately notice which
words deserve a greater amount of your attention regarding spelling and
pronunciation (was it intususception or intussusception,- silhouete or silhouette!).
€XR (Chest Radiograph)
• History:
— Shortness of breath and fever.
• Findings:
— Chest PA and lateral compared with similar study dated 6 September
2005 shows normal cardiomediastinal silhouette. The costophrenic
sulci are sharp. The lungs are clear. There has been no significant interval change since the prior examination.
• Impression:
— Normal chest radiograph.
KUB (Kidney Ureter and Bladder)
(KUB is the usual term for conventional abdominal radiographs.)
• History:
— Abdominal pain.
• Findings:
— Abdominal series consisting of supine and upright radiographs of the
abdomen shows unremarkable bowel gas pattern. There is no evidence of free intraperitoneal air. No abnormal calcification or gas distribution is seen.
• Impression:
— Unremarkable abdominal series with no findings to suggest an obstructive process or free intraperitoneal air.
Standard Reports
UGI (Upper Gastrointestinal)
• History:
— Abdominal pain.
• Technique:
— Double contrast UGI study is performed by administration of thick
and thin barium. Real-time fluoroscopic examination is complimented
with spot images and overhead radiographs.
• Findings:
— Patient is able to swallow without difficulty. Contrast material coating
of the esophagus, stomach and duodenal bulb shows no ulceration or
abnormal contour. The esophagus is of normal caliber. Contrast material transits into the stomach and duodenum unobstructed. Peristaltic
waves are observed. The esophagus, stomach and duodenal bulb are
pliable. No hiatal hernia is seen. Provocative maneuvers do not elicit
gastroesophageal reflux.
• Impression:
— Normal UGI study.
Barium Enema
• Clinical history:
— Recent forty pound weight loss.
• Findings:
— Normal ascending, transverse, descending, and sigmoid colon, and
rectum with no evidence of stricture or mass. Contrast material refluxed into normal-appearing terminal ileum.
• Impression:
— Normal.
• History:
— Screening mammogram.
• Technique:
— Standard mammographic views are obtained in the MLO and CC projection with digital mammography. CAD is applied. There is no prior
mammogram for comparison. This is a baseline mammogram.
Unit XII Standard Normal Reports
• Findings:
— Bilateral breasts: there are scattered fibroglandular densities. No significant calcification, architectural distortion or mass is seen.
• Impression:
— BIRADS 1 — normal.
Breast Sonography
• Clinical history:
— Palpable mass and area of diffuse palpable nodularity.
• Findings:
— Examination reveals no evidence of focal mass or cyst. Images compatible with focal fibroglandular tissue are noted.
• Impression:
— No sonographic correlation with mammographic/palpable findings.
Chest CT Scan
• History:
— Shortness of breath.
• Technique:
— Multiple axial images of the chest from the thoracic inlet to the upper
abdomen are acquired without intravenous contrast material. 5-mm
contiguous axial images are reconstructed. There is no prior CT of
the chest for comparison.
• Findings:
— There is no axillary, mediastinal or hilar lymphadenopathy. The lungs
are clear. Cardiac size within normal limits. No pericardial or pleural
effusion is present. Imaged bones and soft tissues are unremarkable.
• Impression:
— Normal chest CT scan.
Standard Reports
Abdomen/Pelvis CT Scan
• History:
— LUQ pain.
• Technique:
— Multiple axial images of the abdomen and pelvis from the lung bases
to the ischial tuberosities are acquired in coordination with intravenous administration of 100 ml [contrast agent] and oral contrast
agent. 5-mm contiguous axial images are reconstructed. There is no
prior CT of the abdomen/pelvis for comparison.
• Findings:
— Lung bases are clear.
- Abdomen: Liver has normal contour and density. Spleen, pancreas,
adrenal glands and gallbladder are unremarkable. Kidneys enhance
symmetrically. No lymph nodes in the abdomen are abnormally enlarged.
- Pelvis: Opacified loops of large and small bowel are unremarkable.
There is no free fluid in the pelvis. No lymph nodes are abnormally
enlarged. The urinary bladder has a normal configuration.
— No bony lesion is suspicious for malignancy.
• Impression:
— Normal CT scan of the abdomen and pelvis.
Abdomen Ultrasonography
• History:
— Right upper quadrant pain.
• Findings:
— Real-time ultrasound examination of the abdomen shows normal liver
contour and echotexture. The kidneys measure ... cm (left) and ... cm
(right). Spleen and pancreatic head are unremarkable. The pancreatic
tail is obscured by overlying bowel gas. The gallbladder is distended
but no pericholecystic fluid or gallbladder wall thickening is present.
No sonographic Murphy’s sign could be elicited. The common bile
duct measures 3 mm. There is no intra- or extrahepatic biliary ductal
dilatation. The aorta diameter is 1.5 cm at the level of the renal arteries.
• Impression:
— Normal abdominal ultrasound.
Unit XII Standard Normal Reports
Head CT Scan
• History:
— Headache.
• Technique:
— Multiple axial images of the head are obtained from the skull base to
the high convexities without administration of intravenous contrast
agent. No similar prior study is available for comparison.
• Findings:
— There is no intra- or extraaxial hemorrhage, midline shift, or mass effect. The normal grey—white differentiation is preserved. The ventricle
and sulci are of expected size and morphology for the patient’s age.
Imaged paranasal sinuses and mastoid air cells are clear.
• Impression:
— Normal CT scan of the head.
Neck CT Scan
• History:
— Hoarseness.
• Technique:
— CT images in the axial plane were obtained from the level of the frontal sinuses inferiorly to the thoracic inlet following the uneventful administration of intravenous contrast agent.
• Findings:
— The spaces of the neck are normal in appearance. There are no enlarged lymph nodes, nor nodes with low-density centers. There are
no abnormal areas of enhancement demonstrated.
• Impression:
— Normal contrast-enhanced neck CT scan.
Head MR Scan
• History:
— Headache.
• Technique:
— Multiplanar multisequence MR images of the brain are obtained before and after intravenous administration of 20 ml of gadoliniumDTPA. Sequences obtained include: axial T1, sagittal T1, axial FLAIR,
axial T2, DWI, axial/coronal TI post-gadolinium administration. No
similar prior study is available for comparison.
Standard Reports
• Findings:
— No signal abnormality is seen on the T1-W or T2-W images. Normal
flow voids are seen in the major intracranial vessels. The ventricles
and sulci are of expected size and morphology for the patient’s age.
There is no abnormal restriction of diffusion. Following administration of gadolinium, no abnormal enhancement is seen. The imaged
paranasal sinuses and mastoid air cells are clear. Globes and orbits
are unremarkable.
• Impression:
— Normal MRI of the brain.
MRI of the Cervical Spine
• History:
— Pain and paresthesias in left arm.
• Technique:
— The following imaging sequences were performed: Sagittal TI-W and
T2-W images from the foramen magnum to the T2 level. Axial T2-W
images from the C2 level inferiorly through the T1 level.
• Findings:
— The cervical spine is anatomic in alignment. There is no evidence of
posterior disc protrusions. The spinal canal is adequately patent. No
cord signal abnormalities are demonstrated.
— Axial images at the C2—3 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the C3—4 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the C4—5 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the CS—6 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the C6—7 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the C7—T1 level: the spinal canal and neural foramina
are adequately patent.
• Impression:
— Normal cervical spine MRI.
Unit XII Standard Normal Reports
MRI of the Lumbosacral Spine
• History:
— Right radiculopathy.
• Technique:
— Sagittal TI-W and T2-W images were performed from the T12 level
inferiorly to the S2 level. Axial TI-W and T2-W images were performed from the L3 level through the SI level.
• Findings:
— The alignment of the lumbosacral spine is anatomic. There is no evidence of disc herniation. There is a normal disc hydration signal
demonstrated. The conus medullaris is normal in signal intensity.
— Axial images at the L2—3 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the L3—4 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the L4—5 level: the spinal canal and neural foramina
are adequately patent.
— Axial images at the L5—S1 level: the spinal canal and neural foramina
are adequately patent.
• Impression:
— Normal lumbosacral spine MRI.
• History:
— Abdominal pain.
• Findings:
— The lungs are clear and normally inflated. The cardiothymic silhouette is within normal limits. The bowel gas pattern is unremarkable
with no sign of abnormal distention or obstruction. No free air or airfluid levels are seen on the supine view. There is no evidence of
organomegaly or abnormal calcifications. No bony abnormalities are
• Impression:
— Normal babygram.
Standard Reports
Air Enema for Intussusception Reduction
• History:
— Suspected intussusception.
• Findings:
— After informed consent was obtained from the patient’s mother, a
rubber catheter was placed in the rectum and air was gently insufflated by hand pressure. Air filled a normal colon with no intraluminal filling defect to suggest the presence of intussusception. Reflux of
air into the terminal ileum and distention of small bowel was noted.
• Impression:
— No evidence of intussusception by air enema.
Pediatric Renal and Bladder Sonography
• History:
— Trace hydronephrosis on prenatal ultrasound scan.
• Findings:
— The right kidney measures ... cm in length and the left kidney measures ... cm.
— There is no evidence of hydronephrosis, hydroureter or stones. Renal
echogenicity is within normal limits.
— The filled bladder contains ... ml of urine and shows no debris or
stones. Bladder wall thickness is normal. There is no post-void residual.
• Impression:
— Normal renal and bladder ultrasound scan.
Aortogram and Bilateral Runoff
• Preprocedure diagnosis:
— Bilateral claudication.
• Postprocedure diagnosis:
— Status post-abdominal aortography, bilateral pelvic oblique angiography, and bilateral lower extremity runoff.
• Physicians:
— Dr. Smith, Dr. Prodi.
• Procedures performed:
— Right common femoral (left common femoral, left humeral) artery
Unit XII Standard Normal Reports
— Abdominal aortography.
— Nonselective bilateral pelvic oblique angiography.
— Bilateral lower extremity runoff angiography.
• Anesthesia and medication:
— 5 ml 1% lidocaine locally to right CFA (left CFA, left humeral artery)
puncture site; intravenous Fentanyl and Versed as per usual conscious
sedation protocol.
• Description of procedure:
— Informed consent was obtained.
— The patient was prepped and draped in the usual sterile fashion.
— The right/left CFA (common femoral artery) was localized by palpation. 1% lidocaine solution was infiltrated subcutaneously and into
the soft tissues adjacent to the right/left CFA, which in turn was entered using the Seldinger technique.
— A guidewire was threaded to the suprarenal abdominal aorta and appropriate puncture site dilatation to 5F was achieved over the wire.
— A 5F pigtail catheter was placed over the wire in the abdominal aorta
with its tip at the level of the main renal arteries, which was confirmed with the hand injection of 5 ml contrast agent.
— Abdominal aortography in the AP (lateral, and shallow LAO) projection was performed. The catheter was partially withdrawn to just
above the aortic bifurcation and bilateral pelvic oblique angiograms
were obtained. Using the station-by-station method, bilateral lower
extremity runoff was then accomplished. The pigtail catheter was removed and manual pressure was applied for 15 minutes to achieve hemostasis. No significant groin hematoma was found and bilateral lower extremity pulses were unchanged as compared with preprocedure.
The patient tolerated the procedure well, with no immediate complications, and was returned to the ward in good condition.
• Findings:
— The abdominal aorta is patent and demonstrates normal caliber. The
celiac artery, SMA, and IMA are patent and without significant stenoses. Right and left renal arteries are identified and are without significant disease. The bilateral common iliac, internal iliac, and external iliac arteries are patent and without significant stenoses.
— The right PFA, SFA, popliteal artery, anterior tibial artery, tibioperoneal trunk, peroneal artery, posterior tibial artery, dorsalis pedis artery, and primary pedal arch are patent and without significant stenoses or occlusions.
— The left PFA, SFA, popliteal artery, anterior tibial artery, tibioperoneal
trunk, peroneal artery, posterior tibial artery, dorsalis pedis artery,
and primary pedal arch are patent and without significant stenoses or
Standard Reports
• Impression:
— Successful abdominal aortogram, bilateral pelvic angiogram, and bilateral lower extremity runoff demonstrating no significant abnormalities.
CT-Guided Abscess Drainage
• Preprocedure diagnosis:
— Presacral abscess.
• Postprocedure diagnosis:
— Status after successful placement of 12F catheter in presacral space.
• Physicians:
— Dr. Walker, Dr. Ho.
• Procedures performed:
— Limited CT scan of pelvis to localize abscess in presacral space.
— CT-guided penetration of 19 gauge needle with aspiration of 120 ml
— Fluoroscopically guided placement of l2F drainage catheter over a
wire into presacral space.
— Injection of iodinated contrast agent through drainage catheter to
confirm its position and evaluate cavity.
• Anesthesia and medication:
— 5 ml 1% lidocaine in soft tissues overlying the target of drainage.
• Description of procedure and findings:
— Informed consent was obtained. The patient was prepped and draped
in the usual sterile fashion. A limited noncontrast CT scan of the pelvis was performed, revealing a presacral abscess. The soft tissues of
the right gluteal region were infiltrated with lidocaine for local anesthesia and a l-cm 25-gauge needle was left in place. A repeat CT
scan was perfumed to confirm the position of the needle relative to
the fluid collection. A 19-gauge needle was attached to a syringe and
advanced parallel to the marker needle and into the fluid collection,
with immediate aspiration of 120 ml pus when the needle penetrated
the fluid collection. The syringe and marker needle were removed
and a wire was advanced through the needle under fluoroscopic observation. The needle was removed and serial dilatation to 12F was
achieved over the wire. A 12F drainage catheter was advanced over
the wire into the cavity. The wire was removed, the catheter loop was
secured, and the catheter position was confirmed fluoroscopically with
injection of several milliliters of iodinated contrast agent. The drainage catheter was secured to the skin with a single 0 silk suture and
the exit site was covered with a dry sterile dressing.
Unit XII Standard Normal Reports
— The patient tolerated the procedure well, with no immediate complications, and was returned to the ward in good condition.
• Impression:
— Status after successful CT and fluoroscopically guided drainage of presacral abscess.
IVC Filter Placement
• Preprocedure diagnosis:
— Clot in the right superficial femoral vein in a 66-year-old male patient.
• Postprocedure diagnosis:
— Status after successful placement of infrarenal IVC filter.
• Procedures performed:
— Ultrasound-guided micropuncture of (right internal jugular, right
common femoral) vein.
— Inferior vena cavogram.
— Fluoroscopically guided placement of IVC filter in the infrarenal IVC.
• Anesthesia and medication:
— 5 ml 1% lidocaine at the venous puncture site.
• Description of procedure and findings:
— Informed consent was obtained. Patency of the (right internal jugular
vein, right common femoral vein) was confirmed by ultrasound. The
patient was prepped and draped in the usual sterile fashion. Lidocaine
was infiltrated into the soft tissues over the venous puncture site. The
(right UV, right CFV) was entered using a micropuncture technique.
A 0.018-inch guidewire was threaded and appropriate dilatation to 5F
was achieved over the wire. The wire was replaced with a 0.035 wire,
with its tip in the IVC. A 5F pigtail catheter was placed over the wire
with tip near the IVC bifurcation and the wire was removed. An inferior vena cavogram was performed to determine the level of the renal
veins. The catheter was removed over the wire, progressive dilatation
to 12F was achieved, and the 14F introducer sheath was placed with
its tip inferior to the renal veins. The wire was removed. An IVC filter
was loaded into the introducer and deployed in the infrarenal IVC under fluoroscopic observation. The introducer was removed and hemostasis was achieved with 10 minutes of manual pressure. The patient tolerated the procedure well, with no immediate complications,
and was returned to the ward in stable condition.
• Impression:
— Successful placement of IVC filter in the infrarenal IVC.
Your First Radiological Reports
Your First Radiologi«al Reports in English
Our advice is that you must use standard normal reports as a reference
and build several “pluripathological” reports which include the most common abnormalities so that you can simply choose the sentences that fit
your particular case. Once again write the sentences containing either normal findings or common pathology so that you become familiar with their
Let us have a look at this example of a “pluripathological” knee MR report which includes many usual expressions, sentences, and collocations
that can help you in your first reports in English. (The following report
does not intend to be a comprehensive MR knee report but a simple exercise to give you an idea of how to write your own standard reports.):
1. No degenerative osseous changes are seen.
11. Gonarthrosis.
2. Femoropatellar joint is unremarkable.
21. Free intraarticular fluid.
22. No images of chondromalacia are seen.
23. Diffuse hyperintensity on T2-W images of the hyaline cartilage of
the patella consistent with grade 1 chondromalacia.
24. Irregularity of the surface of the external aspect of the hyaline cartilage of the patella consistent with grade 2 chondromalacia.
25. External/internal patellar subluxation.
26. External/internal patellar luxation.
27. Patella’s retinacula without images of disruption.
28. Internal/external retinaculum partial tear.
29. Internal/external retinaculum complete tear.
210. Medial/suprapatellar/infrapatellar patellar plica is unremarkable.
211. Medial patellar plica is thickened and trapped between the patella
and the femur; the finding is consistent with plica syndrome.
3. Anterior cruciate ligament (ACL) is intact.
31. Partial/complete tear of the ACL.
32. Intact ACL graft.
33. Torn ACL graft.
34. ACL cyst.
4. Posterior cruciate ligament (PCL) is intact.
41. Partial/complete tear of the PCL.
42. PCL cyst.
5. Medial collateral ligament (MCL) is intact.
51. Distension (grade 1 lesion) of MCL.
52. Abnormal signal intensity secondary to grade 2 lesion of MCL.
53. Complete tear (grade 3 lesion) of MCL.
Unit XII Standard Normal Reports
6. Lateral collateral ligament (LCL) is intact.
61. Distension (grade 1 lesion) of LCL.
62. Abnormal signal intensity secondary to grade 2 lesion of LCL.
63. Complete tear (grade 3 lesion) of LCL.
7. Popliteus tendon is intact.
71. Torn popliteus tendon.
8. Iliotibial band is intact.
81. Fluid around the iliotibial (IT) band consistent with iliotibial syndrome.
9. Menisci are unremarkable.
91. Grade 1 lesion of the body or anterior/posterior horn of the medial/lateral meniscus.
92. Grade 2 lesion of the body or anterior/posterior horn of the medial/lateral meniscus.
93. Oblique=horizontal, vertical, peripheral, radial (parrot beak) tear
(grade 3 lesion) of the body or anterior/posterior horn of the internal meniscus.
94. Bucket-handle tear of the internal meniscus.
95. Meniscocapsular separation.
96. Internal meniscus parameniscal cyst.
97. External meniscus parameniscal cyst.
10. Quadriceps tendon is unremarkable.
101. Partial/complete tear of the quadriceps tendon.
11. Patellar tendon is unremarkable.
111. Partial tear of the proximal portion of the patellar tendon (jumper’s knee).
12. No images of bursitis are seen.
121. Popliteal (Baker’s) cyst.
122. Prepatellar bursitis.
123. Pes anserinus bursitis.
124. Semimembranous tibial collateral ligament bursitis.
125. Tibial collateral ligament bursitis.
126. Medial collateral ligament bursitis.
13. No images of bone contusion are seen.
131. Bone contusion on the medial/lateral femoral condyle/tibial plateau.
132. No osteochondral lesions are seen.
133. Osteochondral lesion on the articular surface of the medial/lateral
femoral condyle/tibial plateau/patella.
134. Osteochondritis dissecans on the articular surface of the medial/
lateral femoral condyle/tibial plateau/patella.
14. No soft tissue lesions are seen.
141. Plantaris tendon partial/complete tear (tennis leg).
Elaborate the reports you are usually required to dictate and use them systematically.
���� ����
Unit XIII Reporting in English
The scarcity of linguistic guidelines and the lack of consensus about what
constitutes a good report are two of the main reasons why most residents
receive little formal instruction in dictating radiological reports.
Although the elaboration of a radiological report may depend on the
style, preferences, and even biases of each radiologist, a certain standard
must be followed. In this unit we show some examples of the most common sentences you can use to write radiological reports. Most examples
are most suitable for CT and MR imaging since these are the studies that
are most commonly reported in tele-radiology.
This unit contains a short section on dictating radiological reports
where tips on the dictation rhythm, usual dictation mistakes and misunderstandings, and the use of punctuation signs are given.
Usual Expressions Used in Reporting
Clinical History
• Sarcoid
- [say the disease].
• Assess for, Evaluate for
- Assess for metastases.
- Evaluate for metastases/meniscal tear.
• Suspected
- SuspeCted pneumonia/pneumothorax/ACL tear.
• Rule out
— Rule out meta5tases/joint effusion/fracture.
• Status post
- The patient is status post left knee arthroplasty/medial meniscectomy.
Unit XIII Reporting in English
• Was/were performed
— Multiplanar imaging of the left knee was performed using the standard
• Was/were obtained
— AP/Frontal, lateral and tangential/oblique v iews of the [left knee] were
• There is no evidence of
— There is no evidence of active bleeding.
- There is no evidence of drainable abscess collection, glenohumeral joint
effusion or osteomyelitis.
• Suggestive of
- TheSe findings are suggestive of CCL tear.
• There is suggestion of
- There is suggestion of mild positive ulnar variance aSsOciated with subChondral cystiC Changes Seen in the Innate.
• Consistent with/(most) compatible with
— Consistent with/compatible with pneumoniayenChondroma ...
— TLie pattern of inflammatory change is most compatible with rheumatoid arthritis.
— These findings are consistent with the patient’s history of spondfloepipiiyseal dysplasia.
— There is mild signal abnormality Seen in the supraspinatus tendon at
its insertion, consistent with tendinosis.
• Is/Are unremarkable, is/are intact, appear normal, is/are normal
- The popliteal vessels are unremarkable.
- The anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and lateral collateral ligament complex are intact.
- The patellofemoral compartment appears normal.
- The medial meniscus is intoCt.
— Bone mineralisation is normal.
• To a lesser extent/degree; to a greater extent/degree
- Degenerative changes are seen in the PIP joint of the thumb. To a lesser
degree there iS mild joint space narrowing Seen in the DIP joints of the
1st, 3rd, 4th, and 5th fingers.
Usual Expressions Used in Reporting
• There is/are, is/are pre5ent, is/are seen, is/are visualized, is/are identified
- There is lateral/medial subluxation of the patella.
— There iS focal/diffuse bone marrow edema.
— There is no chondromalacia of the patella or osteochondral defeCt
within the patella.
- Osteophyte formation is seen in the patellofemoral compartment.
- There is a physiological amount of joint fluid.
- A discoid lateral meniSCus is present.
— No acute fracture is identified.
— No focal COFtilage defeCtS are seen.
• Within normal limits
— Popliteal artery and vein are within normal limits.
- Marrow signal is age appropriate and within normal limits.
• Remainder/remaining
— The remainder of the pelvis iS unremarkable.
- The remainder of the bones and Curtilage Spaces, inCluding the hip,
appear normal.
— Remaining visualized bones are without evidence of fracture or dislocation.
• Associated with
— Mild positive ulnar variance associated with ChOndromalacia of the
• Right greater than left
- Multiple erosions throughout both hands are seen, right greater than
left, consistent with given history of JRA.
• Age appropriate
— MOFroW signal iS age appropriate and within normal limits.
• Involving
- There is a tear involving the body and posterior horn of the lateral
men isCuS.
— There is diffuse osteopenia, particularly involving the greater and
lesser trochanters bllaterally, consistent with stress shielding.
• (Most/less) likely represent
— There are mixed sClerotiC Ond luCent lesions in the tips of the scapulae
bilaterally with the appearance of a chondroid matrix. These findings
most likely represent enchondromas. Less likely on the differential
would be metastasis.
- In the left hip, there is a lucenc y at the lateral aSpeCt of the femoral
component stem, most likely representing granulation response.
Unit XIII Reporting in English
• Seen best on/in
- There is elevation of the menisCuS at its rOOt Attachment Seen best on
the coronal sequences with the avulsed fragment elevated in relation to
the body of the lateral meniSCblS.
- There is some irregularit y noted of the distal fibula seen best in the
oblique view.
• Incidental note made of
- Incidental note made of linear low signal abnormalit y extending centrally into the patellofemoral joint.
• Note is made ...
— Note iS made of an accessory soleus muscle.
• For further evaluation
- A bone Scan is reCommended for further evaluation.
• Is noted
- SubCutaneous edema is noted along the lateral superfiClal 5oft tissues
about the knee.
• About (around)
- Subcutaneous edema iS noted along the lateral superfiClal 5oft tissues
about the knee.
— There is a joint effusion about the ankle.
• Throughout (in all parts of)
— Normal bone marFOw Signal is identified throughout the knee.
• Show/reveal/demonstrate
— AP and lateral views of the left tibia and fibula reveal/show no evidence of fracture or malalignment.
- Review of the bone windows demonstrates no bony abnormalit y.
• Interval development
- Three views of the right ankle are compared with the prior study from
[date] and reveal interval development of abnormal soft-tissue densit y
overlying the right heel extending to the posterior aspect of the calcaneus which demonstrates irregularit y of the cortical surface.
Describing Different Radiological Features
• Enhancement
- After administration of gadolinium there is mild enhancement at ...
- After administration of gadolinium no enhanCement iS seen at ...
— No abnormal muscular edema or enhancement is Seen.
Usual Expressions Used in Reporting
• Fracture
- There is a non-displaced/displaced froCture of [say the bone] with/
without intraarticular extension.
— There is widening of the [say the joint] joint.
- There is a fracture through the proximal lateral aspect of the [fibula
...]. The conjoined tendon iS Attached to the avulsed fragment.
- No acute fracture or marrow edema is seen in the [distal femur, proxi— Standard views of the left wrist demonstrate transverse fracture with
mild impaction of the distol YadiuS. There is no definite extension to
the artiCular surfaCe. Remaining v isualized bones are without evidence
of fracture or dislocation. There is soft-tissue swelling and possible hematoma over the anterior surface of the wrist and hands.
- There is an acute fracture of the lateral tibial plateau which is comminuted and extends to the articulaY Surface. ASsOciated edema is
- The left transverse process of L5 is fYaCtured.
• Degenerative changes
- Small marginal osteophytes are seen in all three compartments.
- Subchondral osteophytes and sclerosis are seen in the lateral femoral
— There are well-defined erosions with sclerotiC borders on both sides of
the joint.
• Soft tissue mass
- The right thigh shows no soft tissue or bone abnormalit y.
- The present StHdy shOws increase in size of a lobulated mass located in
the left adductor longus muscle. It presently measures 5.7 x 4.3 cm.
Compared with the prior study in addition to the increase in size, the
lesion now has a heterogeneous Signal w ith fluid-fluid levels indicating
the presence of blood produCts.
- There is surrounding muscle edema aS seen on the prior examination.
- After the intravenous admlHlS tration of gadolinium the lesion enhances
peripherally. There is also enhancement of the adjacent muscle where
edema was v isualized.
- The mass is again seen in proximit y to the superfiClal femoral artery
which appears preserved.
• Elbow example (lateral epicondylitis)
- The medial elbow tendons are normal. Laterally, abnormal increased
signal involving the common extensor tendon at its Attachment to the
lateral humeral epicondyle is noted. Some surrounding fluid at this site
IS also noted. Superficially, there is SOft tissue prominence noted,
acCountiRg fOr the CliillColly palpable soft tissue “mass”. findings are
most consistent with lateral epicondylitis with high-grade partial tear
involving the attachment of the common extensor tendon.
Unit XIII Reporting in English
• Shoulder example
- There is a significant amount of fluid seen along the subdeltoid bursa
with a lesser amount along the subacromial bursa. Additionally, a
small heterogeneous signal lesion is seen in the subdeltoid bursa adjacent to the biceps tendon likely corresponding to the calcification seen
on the prior radiograph. No glenohumeral effusion seen. No evidence
of abscess formation seen. Anterior subcutaneous T2 hyperintensit y
likely corresponding to prior joint aspiration.
• Plain film examples
- AP, lateral and sunrise views of the left knee reveal osteophyte formations, subchondral sclerosis and cartilaginous space narrowing at the
patellofemoral, medial and lateral tibial femoral compartments. There
IS nO Soft tissue abnormalit y. AP and lateral views of the left tibia and
fibula reveal no evidence of froCture or malalignment. Bone mineraliZOtiOR iS HOrYllOl.
— AP and lateral views of the thoraCiC spine show nO fracture or dislocation. The bones and COFtilage spaces appear normal. No soft tissue
abnormalities are seen. In these v iews, the right ShOulder and scapula
appear normal.
• Technique
— AP/Frontal, lateral and tangential/oblique views of the [left knee ...]
were obtained.
— Comparison is made with radiographs of the same date at 18:47 hours.
— No prior studies are available for comparison.
- Compared with the prior study, there has been ...
• Miscellaneous
- A marker is pointing to the palpable mass/DIP joint of the 2nd digit.
- This is unchanged in size and appearance compared with prior plain
film ... and its appearance is consistent with that of a giant bone island.
- There is no evidence of fracture or dislocation.
— Bony mineralization is normal.
- No osteolytic or osteoblastic lesions are seen.
- Two views of the right knee and two views of the right femur are Submitted for evaluation without prior studies for compariSOn.
— CompaYlSOTl IS made with the CT performed [date].
- Note is made of a thin dark linear structure seen within the tendon
sheath of the flexor digitorum longus consistent with a 5 yneChia.
— Metastasis or other tumors cannot be ruled out.
- There is no MRI evidence for a neoplaSlTl OF abnormal soft tissue
— No signifiCont joint effusion is identified.
Usual Expressions Used in Reporting
Knee MR Report
• Clinical history
— Left knee pain, swelling, status post-skiing injury. Evaluate for meniScal tear or bone bruise. Rule out meniSCal tear.
• Protocol
— Multiplanar MR images of the left knee were obtained using the Stan-
dard protocol.
— Multiplanar sequences were obtained of both knees with and without
the intravenous administration of gadolinium, using a knee Coil.
- Routine MR protOCOl Of the knee was performed.
— No prior studies are available for comparison.
— A COlTlparison is made with the prior examination dated 27 November
— Utilizing a dedicated coil, multiplanar sequences of the i left knee ...
were acquired without gadolinium administration.
• Menisci
— A discoid lateral/medial meniscus is present.
- The medial and lateral menisci are intact.
— There is a (complex) tear involving the [anterior/poSteriOr horn, body]
of the lateral/medial menisCuS.
• Cruciate ligaments
— The posterior/anterior cruciate ligament is intact.
- The anterior and posterior cruciate ligaments are intact.
- There is a full-thickness tear of the ACL/PCL Ot its femoral/tibial insertion.
— The PCL/ACL remains intoCt.
- There is a complete tear of the anterior/posterior cruCiate ligament.
• Collateral ligaments/extensor mechanism
- The medial and lateral collateral ligaments are intact. The extensor
mechanism is intact.
- The medial and lateral COllateral ligament complex and extensor meChanism are intact.
— Grade 1/Grade 2 sprain of the medial/lateral collateral ligament.
— The MCL/LCL is thickened but intact. The appearance of the MCL/LCL
in the setting of surrounding edema iS CORSiStent with MCL/LCL
— The lateral collateral ligament complex including the conjoined tendon
remains intact.
• Cartilage
— The lateral tibiofemoral and medial tibiofemoral COmpartments are
— There is no focal osteochondral defect.
Unit XIII Reporting in English
- There is a focal narrow area of high signal within the cartilage of the
medial patellar facet Consistent with a deep fissure.
— Deep fissure within the cartilage of the medial patellar facet.
— There is diffuse thinning of cartilage along the medial femoral Condyle.
- No focal cartilage defect seen in the lateral compartment.
- There is mild cartilage thinning of the medial and lateral compartments.
- The articular COYtilage within the knee is normal.
— There is a ... cm defect within the cartilage along the [lateral tibial
plateau ...]. with approximately ... mm of depression.
- The medial tibiofemoral compartment has no foCal COFtilaginous defect.
— The patellofemoral compartment appears normal.
• Bones
— £xtenSive bone marrow signal abnormalit y within the femur, tibia and
fibula, Sparing the epiphysis, is low on T1 and heterogeneously bright
on STIR. This is consistent with the patient’s history of knOW n Sickle
cell anemia with early bone marrow edema.
- There is abnormal signal within the [anterior/posterior lateral/medial
tibial plateau/femoral condyle] consistent with a bone bruise.
— No other abnormal bony findings are Seen.
— There is no bone marrow edema.
- Normal bone marrow signal is identified throughout the knee.
• Other (miscellaneous)
- There is no significant joint effuSlOTl.
- There i5 a large joint effusion.
— There is a mild/moderate [Say the joint] joint effusion.
- There is a physiological amount of joint fluid.
— There are no muscle abnormalities/soft tissue edema.
— Soft tissue swelling is present around the site of injury.
- A small popliteal cyst is identified.
- No popliteal cyst is identified.
— Prepatellar subcutaneous edema.
- There is no evidence of acute fracture or dislocation.
- There is no signiflCant joint Space narrowing.
— Early tricompartmental osteoarthritic changes.
- There is focal high signal demonstrated within the patellar tendon
near its insertion.
— There iS nO chOndromalacia of the patella or osteochondral defect within the patella.
- There is minimal lateral S Hbluxation Of the patella.
— There is lateral subluxation of the patella.
— OSteophyte formation is seen in the patellofemoral compartment/medial tibiofemoral COlTlpartment/lateral tibiofemoral compartment.
Usual Expressions Used in Reporting
- I say the muscle is surrounded by fluid and demonstrates increased
signal within the substance of the tendon. Findings are Consistent with
extensive partial tear.
— Fluid is present within the tendon sheath of [SOy the musCle], consistent with tenosynov itis
• Recommendations
- Six-week MR fOllow-up to assess for healing IS appropriate if CliRlCOll f'
— Further evaluation by pelvic sonography or MRI is recommended.
- Further evaluation with arthroscop y may be of further diagnostic value.
— Findings were called in to the orthopedic resident/attending at the time
of dictation.
- This result was paged to beeper number 111111 at the time of interpretation.
— S mm nodular opacit y in the right lower lobe is indeterminate. If a prior
study is available, it may be used to establish stabilit y. Alterna- tively, a
repeat study may be obtained in ... months.
- The 4 mm right adrenal nodule has Signal characteristiCS COmpatible
with an adenoma. No further imaging is recommended unless the patients clinical status changes.
— Short segment inflammation of the descending colon may be a manifestation of diverticulitis but the aS ymmetric wall thickening i5 COHcerning. Further study should be considered once the acute inflammation has resolved to exClude an underlying proCesS.
- Incidentally seen right adnexal C ystic mass is not adequately evaluated
on CT. A pelvic ultrasound scan would be the next study of choice.
• CT/MR limitations
— Image qualit y is degraded by motion.
— Images of the pelvis are limited by streak artifact from the right hip
- Degree of contrast opacification of the pulmonary artery is not adequate to exclude a pulmonary embolus.
- Absence of intravenous controst lowers the sensitivit y of the study for
detection of VaSCH lar lesions.
— PreSence of intravenous COHtrast lowers sensitiv ity of the study for detection of small renal stones.
Unit XIII Reporting in English
Di«tating a Radiological Report
Appropriate dictating either to a secretary or to a speech recognition device results in faster report turnaround and reduces waiting times for patients and referring physicians.
Many radiologiSt5 are convinced that dictating quickly serves to expedite
the work and is a reflection of their knowledge of radiology. Accordingly,
residents are perceived as slow dictators, a notion supported in part by the
their lack of experience and emerging knowledge base. In our opinion,
both ideas are incomplete. The sensation of having done the work is false
unless the dictation is complete and correct. Hence, clear and error-free
dictation is paramount.
The first piece of advice to dictate reports is: talk to your secretary! (or,
in this era of speech recognition systems, train your speech recognition
software!). Tell your secretary to make a list of his/her mistakes and think
about how many of them could have been avoided with better dictation.
When I was a research fellow at Brigham and Women’s Hospital in Boston I wondered why the attending radiologist cleared his throat at the end
of certain reports. As time went by I realized that this experienced and “fastdictating” radiologist only cleared his throat at the end of the reports of
patients suffering from ... hiatal hernia! The way in which he said “hia- tal
hernia” was absolutely impossible to understand not only by me but by every
foreign resident rotating in this section at that time. From then on that
extraordinarily fast “hiatal hernia” comes to my mind whenever I have to
clear my throat giving a lecture.
Standard Dictation
1. “This is Dr. ... dictating” <your name>
2. “Dictating with” <attending’s name> (only if you are a resident or fellow)
3. “Patient” <patient’s name>, “accession number” <accession no. of the
4. “Chest PA and lateral, KUB, MR with and without contrast ...” <study
5. “Dated” cdate and time of study>
6. “Compared with” <comparison studies, if available>
7. “Clinical history:” <given history>
8. Optional: “Technique” <describe the techniques (only dictated for CT
scans, fluoro studies, HSGs and any procedure where technique is significant).
9. “Findings:” many findings that are appropriates
Dictating a Radiological Report
10. “Impression:” <conclude with an impression, usually in numbered bullet format>
11. “End of dictation”
Dictation Example
This is Dr. Smith dictating with Dr. Pole.
Patient Joseph Taylor, Accession number 87654.
Study is chest PA and lateral dated May 21, 04 compared with chest PA
from August 28, 03 at 08:00.
CliRiCOl history <colon> cough and fever <period> <paragraph>
Findings <colon> two views of the chest demonstrate dense medial lobe
consolidation obscuring the right heart border as well as part of the right
hemidiaphragm <comma with interval worsening of the same findings
from prior study +period> Cardiac size is again increased and unchanged
<period> Prior healed rib fractures are again noted on the right side cperiod> <paragraph>
Impression <colon> Number one <comma> medial lobe pneumonia
<commaT worsening as compared with yesterday’s film <period> Number
two <comma> increased heart size <period> End of dictation.
Next patient ...
End of dictation. Thanks.
Dictating Puntuation Marks, Eponyms, Acronyms and Abbreviations
Period (full—stop)
Open parenthesis
Close parenthesis
F in capital letters
In capital letters
Both beginning with capital letters and separated
by a hyphen
Interrogation mark
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Unit XIV Interventional Radiology
IR suites are real-time decision-making environments in which lack of fluency can be troublesome not only for the non-native English-speaking
radiologist but for anybody else in the laboratory, the patient included.
This is the reason why we have dedicated a complete unit to interventional
When you enter an IR suite your listening skills are much more important than your fluency; nobody is expecting you to say too much but
everybody takes for granted that you understand them, and that is not always true. You will find no difficulty when the conversation is on the
pathology itself; in the first few days many jargon terms, acronyms, and
abbreviations can be tricky but, with a bit of help, you will soon feel reasonably confident.
Do you know, for example, what a SOAP note is? If you haven’t worked
in an American hospital, probably not. SOAP stands for (Subjective comments on the patient, Objective findings, Assessment, and Plan) and SOAP
note refers to the standard follow-up chart entries.
One of the main problems of non-native English-speaking interventional
radiologists working in English-speaking IR suites is the lack of knowledge
of basic vocabulary, jargon terminology, acronyms, abbreviations, and set
Let us begin with this simple conversation that may have happened hundreds of times in IR suites. Familiarity with conversations such as the following will help in our first days in an English-speaking IR suite.
• Radiologist getting ready for case, speaking to IR technologist: “I’ll be
in as soon as I get the cap, facemask, and booties on.”
• IR technologist: “I’ll have your gown ready for you. What size gloves do
you take?”
• Radiologist: “I usually take 8’s but I’m going to double-glove for this
case, so I’ll take 8 under and 8 1/2 on top. Thanks.”
The first thing a foreigner notices in an IR suite is that he/she is not familiar with terminology regarding garments since he/she has not asked for
Unit XIV Interventional Radiology
garments in English before and because virtually nothing has been written
on booties, masks, caps, gowns, etc.
In the following pages we will go over several sentences typical of an IR
suite. Those who have not worked in an IR suite abroad and are not going
to do so in the future may not see the point in reviewing so many easy set
phrases; these sentences are indeed quite easy to understand for an interventional radiologist independently of his English level.
Our advice is try to read them aloud. By doing this not-that-simple exercise you will immediately notice that you may not be confident in reading aloud and pronouncing correctly some of the sentences you used to despise as simple. The best way to become familiar with the listening, pronunciation, and spelling of these sentences is to write them down and read
them aloud.
When, during your first days in a foreign IR suite, you hear some of
these sentences uttered by native speakers you will realize how important
it was to have heard the sentences before, and you should already have
practiced the first sentences you have to say yourself.
Tools and devices are usually well known by foreign radiologists since they
have read about them in the literature. Garments are a different issue.
Since garment terminology is so engrained in the core of the subspecialty,
it is quite difficult to find written garment names; no article is going to
say a word on scrubs, booties, masks, lead aprons, radiation badges ...
The most common formula to ask for anything in this environment is:
• Can I have ...?
Everyone who has rotated in an English-speaking IR suite has felt the need
to ask for garments:
Where are the lead aprons?
Do we have lead aprons?
This lead apron is too small. Can I have a larger one?
Can I have a face mask?
Could you give me a hood?
Can you tell me know where the shoe covers are.
I’ll need a pair of lead gloves.
What size gloves do you take? Eight.
I’m going to double-glove for this case.
I’ll take 8 under and 8 ½ on top.
My scrubs top is soaked. I need to change it.
There is a blood stain on my scrubs pants (UK trousers).
Talking to the Patient
• I left my radiation badge in my locker.
Look at the schematic representation on the following page in which we
have included some of the most common IR garments.
Tools and Devices
Once you are properly dressed, you will have to ask for tools and devices.
Since most tools and devices are known beforehand, we give you a few examples of usual requests and common formulas to ask for guides, stents,
catheters . . .:
Can I have a 0.035 guidewire?
Can I have a hydrophilic guidewire?
Can I have a 5F introducer?
Can I have a 16 G needle?
Give me a 10F nephrostomy tube, please.
Give me an angled Amplatz guidewire, please.
I’d rather use a pig-tail catheter.
The foreign body seems to have a free end; I’ll use an Amplatz goose
neck snare.
• Can I have a torque vise?
• Can I have a stiffer guidewire, please?
Talking to the Patient
“Don’t breathe don’t move” is probably the commonest command in an IR
• Keep still.
• Don’t breathe don’t move.
• Push as if you were going to have a bowel movement (Valsalva maneuver).
• Take a deep breath and bear down as if you are going to have a bowel
movement (Valsalva maneuver).
• Let me know if this hurts (to check if the local anesthetic is working
• Let me know if this stings (to check if the concentration of the local anesthetic in sodium bicarbonate is adequate).
• Do you feel a warm sensation during injection? (to check if the concentration of local anesthetic in sodium bicarbonate is adequate).
• You will feel a burning sensation in your stomach during injection of
the contrast material. It’s nothing to worry about.
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Talking to the Patient’s Family
• Breathe in deeply and hold your breath.
• Breathe in deeply.
• Breath out deeply and hold your breath.
Talking to the Patient’s Family
Before the Procedure
• Your father/husband/mother/wife/son/daughter is about to undergo an
interventional radiology procedure (arteriography, PTA ...). It will take
approximately ... minutes. The procedure does not need a general anesthetic, only local anesthesia, so your father (etc.) will remain conscious.
I will let you know how the procedure went as soon as we finish.
After the Procedure
6ood jews
• Everything has gone fine from a technical point of view; we will look
carefully at the images and the report will be sent to your father’s (etc.)
referring physician. In a few minutes you will see your father (etc.). He
is doing fine. Please make sure he does not move his right leg for 24
Bad jews
I am afraid your father’s condition is critical. He will be transferred to
the ICU.
• Unfortunately, we have not been able to cross the stenosis so the patient
will be transferred to the Department of Vascular Surgery where he will
be operated on on an elective basis.
• There has been a serious complication. Your father is being transferred
to the operating room where he will be operated on now. We (the surgeon and myself) will inform you of the situation as soon as the operation is finished.
Unit XIV Interventional Radiology
Teaching Residents
These are some of the most common commands given in IR suites:
• Prep the patient.
• Drape the patient.
• Make sure that the patient’s groin has been shaved, scrubbed and
• Has the puncture site been scrubbed?
• Locate the right common femoral artery (RCFA) by palpation.
• Locate the left humeral artery by palpation.
• Puncture the artery.
• Do not force the wire.
• Inject local anesthetic as deeply as possible and don’t forget to aspirate
before injecting.
• Tape the lower abdominal pannus back away from the groin.
• Nick the skin with a small blade.
• Use a hemostat to fluoroscopically check the proper position of the intended entry site.
• The skin entry must be over the lower femoral head and the puncture
site over the medial third of the femoral head.
• Advance the needle in a single forward thrust.
• Advance the needle by about 2—3 cm.
• Remove the stylet.
• Retract the needle slowly.
• Gently retract the syringe while keeping the position of the needle
firmly fixed.
• Have you flushed the cath (catheter)?
• Have you checked for free backflow?
• Don’t lose the wire.
• Hold the wire.
• Wipe the guidewire.
• Manipulate gently.
• Don’t forget that the catheter tip migrates cephalad 2—3 cm after upright
• Once the dilator is introduced over the wire, exchange it for the pigtail
• Avoid axillary artery puncture because of the proximity to the brachial
• The stent is not patent.
• The ureter has been perforated.
• There is a clot in the renal pelvis.
• Remove the nephrostomy tube over the wire.
• The initial stent positioning was not appropriate.
• The stent sizing is appropriate.
• Exchange the micropuncture dilator for a peel-away sheath.
Talking to Nurses
The peel-away sheath is kinked at a sharp turn.
Have you aspirated both lumens?
Is there free blood return?
Peel away the sheath.
Introduce the catheter over the wire.
Do not persevere with catheter manipulation.
We could not cross the lesion.
The coil is misplaced.
The coil has migrated into the central venous circulation. Give me a
snare device.
Don’t worry. Venous perforations are usually self-limiting.
Tunneled catheters may have staggered or aligned tips.
If there is no pyonephrosis, use an 8F nephrostomy tube.
Dilate the tract up to the required French size.
Avoid puncturing extrahepatic ducts.
After crossing the stenosis, give 2500 IU of heparin IA.
Size the balloon diameter equal to the adjacent normal vessel measured
on cut-film arteriography.
Cross the stenosis gently.
Extra care must be taken with hydrophilic Glidewire to avoid dissection.
Retract the balloon-catheter leaving the guidewire across the lesion.
Keep the balloon deflated by suctioning with a large-bore syringe.
Talking to Nurses
May I have my gown tied?
Would you tie my gown?
Tie me up, please.
Dance with me (informal way of asking to have your gown tied).
I’ll go scrub in a minute.
Give Dr. Ross a pair of shoe covers.
Give Dr. Ross a thyroid shield.
Give Dr. Ross a lead apron.
Mary, I forgot my thyroid shield. Could you put one on me?
Is the patient monitored yet?
Dr. Cole, there is a phone call for you. It’s Dr. Viamonte. Tell him I’ll call
back later; I can’t break scrub now.
• May I have another pair of gloves, please?
• May I have a pair of lead gloves?
• We’ve had a complication. Page the thoracic surgeon.
Unit XIV Interventional Radiology
Talking to Technologists
Can I have this image magnified, please?
Could you please collimate the image to minimize my hand exposure?
An LPO 45 degrees, please.
Right posterior oblique 45 degrees (side of interest down).
Film at 4 to 6 frames per second during suspended respiration in anteroposterior DSA.
• Road mapping, please.
The lR’s Angiographic Equipment
• The generator provides the electrical energy from which X-rays are generated and contains the circuitry needed to provide a controlled and
stable radiation output. The mid- to high-frequency inverter is the most
popular generator design.
• The X-rap tube is made of a tungsten filament cathode and a spinning
anode disk with a tungsten surface. Electrons go from the cathode to the
anode where they are stopped by its tungsten surface.
• The image intensifies (II) converts the X-ray pattern that penetrates the
patient to an intensified image. Its fields of view range from 4 to 16
inches depending on the magnification factor.
• The patient table is usually made of carbon fiber to provide enough
strength to support an adult patient while minimizing the attenuation of
• The gantry stand contains both the X-ray tube housing with collimator
and the image intensifier/imaging chain.
• High refresh-rate TV monitors are used to reduce flickering of the image
created within the digital TV camera.
• Contrast injectors allow the adjustment of injection volume, peak injection rate, and acceleration to peak rate. Contrast injector arms can be
ceiling-suspended or mounted on the table. The injector control unit can
be on a pedestal in the procedure room or rack-mounted in the control
Some Common ”On Call” Orders for Nurse Units
These are some of the commonest orders for nursing IR units. Non-native
English-speaking interventional radiologists must be familiar with them in
order to be able to write them down on the chart.
Some Common “On Call” Orders for Nurse Units
Patient Preparation
• Premedicate with diazepam (Valium) 10 mg PO (oral intake) given oncall to angiography (optional). Reduce dose for elderly and pediatric patients.
• Obtain informed consent.
• Patients must void urine before leaving the ward for the angiography
• Transfer the patient to the angiography suite with his/her identification
plate, chart, and latest laboratory reports on chart.
• The front cover of the chart should list all precautionary measures
needed to protect the patient (especially if immunocompromised) and
personnel (who may come into contact with patients with infectious diseases).
• Clear fluids only after midnight (for morning appointment).
• Clear fluids only after breakfast (for afternoon appointment).
• Insert Foley catheter.
• Vigorous hydration (NSS at 125 ml/h).
• Prophylactic antibiotics IV.
• Instruct patient to use PCA pump.
• Laboratory check: Hgb/Hct, platelet count, PT/PTT, BUN, and Cr.
• Establish a peripheral IV.
Postprocedure Management
Bed rest for 6 to 8 hours, with puncture site evaluation.
Vigorous hydration (NSS 3 1/34 h) until oral intake is adequate.
Stop analgesics and remove Foley catheter 24 hours after the procedure.
Monitor patient in the recovery room for 6 hours prior to discharge.
IV narcotics (prn).
Forward-flush the drainage catheter with normal saline every 48 hours.
Change the dressing around the drainage catheter every 48 hours.
Leave the catheter to gravity drainage without flushing.
Remove catheter when there is drainage of less than 20 ml/day and vital
signs return to normal.
• Follow-up ultrasound scan in 24 h.
Unit XIV Interventional Radiology
IR Chart Entries
Standard format
An example of a daily chart entry following uterine artery embolization
(UAE) would be a SOAP note (Subjective comments, Objective findings, Assessment, Plan), as follows:
Pt without complaints. No nausea or pain.
T (max) 37.2, 82 bpm, BP: 122/78, u.o = x ml/hour
Pt in NAD
Chest: CTA b
Abdo: benign, S NT, NAD
Groin: No hematoma. Dressing c/d/i
Ext: Warm 2+ DP, 2+ PT. Neuro sensation intact.
A/P : Post UAE day 1
1. Pt doing well post UAE. Pain well controlled.
2. Planning d/c to home this morning.
The first line denotes the service authoring the note and the person writing the
note. In this example, “IR PN-R3” indicates that interventional radiology is the
service authoring the progress note (PN). “R3” refers to the person writing the
note. Typically, R means “resident” followed by the training year (3). Attending
physicians will usually write “Staff”.
S” is a summary of the patient’s subjective comments.
“O” is a summary of objective findings (including vital signs and urine/drain
output) and physical examination (NAD no acute distress; CTA b clear to auscultation bilaterally; S NT soft, nontender; NAD normal active bowel sounds; c/d/i
clean dry intact, DP dorsalis pedis artery; PT posterior tibial artery).
A/P” is a summary of the assessment and plan (d/C discharge).
Some Common “On Call” Orders for Nurse Units
Progress Note
While in-house, patients are followed at least daily. Daily progress notes (PN)
follow the same format. Many in-house patients, particularly unit patients,
have complex issues. While the IR service needs to be aware of all issues,
the progress note is focused on the issues that directly impact our care.
Pt intubated and sedated.
T 36.2—38.4 (presently 37.0), HR 78—102 (presently 86), BP 112—132/
72—88 (presently 122/82), u.o = x ml/hour, percutaneous cholecystostomy output: xx ml/12 hours
Pt intubated
Percutaneous cholecystostomy site c/d/i. Dark green output (volumes
as above).
Abdomen: S NT. Diminished bowel sounds.
Intraprocedure cultures pending.
A/P: Post Perc Chole day 2.
1. Drainage catheter functioning without difficulty. Continue current
2. Will continue to follow daily. Please page xxxx if any questions arise.
Aft Procedure Note
Standard Format
IR procedure note:
(from patient or from appropriate family member if patient
unable to consent)
Guidance modality:
Medications given:
(includes dose)
Needles/Catheters/Device used:
(includes device number)
Specimen sent:
(includes steps taken, management and/or person contacted to assist in management)
(to floor/ICU or holding followed by home if outpatient
Unit XIV Interventional Radiology
fxamp/e i
IR procedure note: CT guided drainage catheter placement
Date/Time: March 3, 2005
Inpatient/Outpatient: Inpatient 6D
History/Indications: 32 y.o. woman involved in MVC with LUQ intraabdominal abscess post splenectomy.
Consent: Written, informed consent obtained from patient.
Radiologist: Dr. Smith
Guidance modality: CT
Medications given: Versed 2 mg, Fentanyl 200 mcg
Needles/Catheters/Device used: 22 gauge x 10 cm needle, 14 French flexima
(serial no. 123456)
Findings: Thick-walled low-density, collection in LUQ contains thick, darkbrown fluid
Specimen sent: 10 ml of dark brown fluid for GS and culture. Total 150 ml
Complication: Trace left pneumothorax. Patient remained hemodynamically
stable through the procedure. 4 hours postprocedure CXR showed no PTX.
Primary physician, Dr. Jones, informed of trace PTX. Plan made for close
observation with repeat CXR if clinical symptoms develop.
Disposition: To floor 6D
fxamp/e 2
IR procedure note: Right IJ (internal jugular) HD (hemodialysis) catheter
Date/Time: March 4, 2005
Inpatient/Outpatient: Outpatient
History/Indications: 63 y.o. male with h/o DM and ESRD in need of venous
access for hemodialysis.
Consent: Informed, written consent obtained from patient.
Radiologist: Dr. Smith
Guidance modality: Fluoroscopy, imaging time < 60 sec
Medications given: Fentanyl xx mcg, Versed xx mg
Needles/Catheters/Device used: MedComp Serial no. 123456
Some Common “On Call” Orders for Nurse Units
Findings: HD catheter placed via right IJ, tunneled to right anterior chest
wall. Catheter tip is in mid RA. No kink along catheter course. No pneumothorax on fluoroscopy. All lumens draw blood back briskly and were
terminally flushed with xxx U/cc of heparin.
Specimen sent: None
Complication: None
Disposition: To dialysis
fxatnple 3
IR procedure note: Right percutaneous renal biopsy
Date/Time: March 2, 2005
Inpatient/Outpatient: Inpatient 5D
History/Indications: 54 y.o. male s/p left nephrectomy in 1997 for RCC.
Newly diagnosed lung adenoCA. New right renal mass.
Consent: Informed written consent obtained from patient.
Radiologist: Dr. Smith
Guidance modality: CT
Medications given: Fentanyl xx mcg, Versed xx mg
Needles/Catheters/Device used: ... (includes device number)
Findings: ...
Specimen sent: Three samples reviewed by cytopathologist at time of
Complication: Trace right subcapsular hematoma. Patient remained hemodynamically stable through the procedure. Primary physician, Dr. Jones, informed of right renal subcapsular hematoma. Plan made for close observation with hematocrit check/repeat CT if clinical symptoms develop.
Disposition: To floor 5C
Contrast Reactions
For contrast reactions, a form rather than chart entry is used. The information is similar and includes:
Type and volume of contrast given
Type and severity of reaction
Action taken
Future recommendation
Unit XIV Interventional Radiology
If the form were to be written, an example would be:
Date/Time: ...
Pt Smith (MR no. 123456) developed a mild facial rash following the administration of 100 ml Ultravist 300. Patient remained hemodynamically
stable and had no dyspnea. Given the mild reaction, no pharmaceutical action was taken. Patient was kept in observation for one hour, during which
the rash resolved with no residual symptoms. Patient was asymptomatic at
time of discharge to home. ER warning was given and contact pager of the
radiologist on call provided. Patient also provided with Contrast Reaction
Card for future reference. Entry of event made into medical record. Patient
instructed that subsequent studies should (a) be done without contrast
agent, (b) be done with proper premedication, or (c) be done using alternative modality requiring no Ultravist. Risks and benefits of study should
be discussed with referring physician and radiologist at time of study.
���� ��
Unit XV On Call
In this unit we review some conversations which might take place during
clinical duties. Calls are a dreadful conversational scenario for beginners
since it is on calls where more real-time decision-making is required and
radiological English is particularly full of acronyms, abbreviations, and radiological jargon.
If you ask an American citizen, lay in medicine, what we mean by POD
and CAC, take for granted that he will not say “postoperative day” and
“clear all corridors”, respectively. Therefore, it is an irrefutable fact that
both medical and radiological English are a universe of their own, and this
is even more true when we talk about calls.
We have tried to compile as many “call terms, sentences, and collocations” as possible in just a few conversations. These sentences do not need
translation or any further comments and any intermediate level Englishspeaking radiologist can understand them easily provided they are within
the appropriate context. Read the sentences aloud and do not let them
catch you off guard.
Common On-€all Sentences
A pager goes off.
The neuroradiologist is Q4 or Q5.
In your next golden weekend ...
Post-call days.
I’ve just reviewed your patient’s MR, and wanted to discuss the findings
with you.
I would like to obtain more information on her presentation and past
surgical history.
Thank you for contacting me regarding Mrs. McHugh’s CT.
There has been no significant interval change in the appearance of ...
I concur with the previous report.
The next study of choice would be ...
ER physician.
To order a brain MR ...
Diagnosed with ...
Admitted for abdominal pain.
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On-Call Conversations
On-Call €onversations
A pager goes off. A radiologist, a cardiologist, and an orthopedic surgeon
are having dinner at the hospital cafeteria:
• “Whose beeper (pager) is going offl.”
• “It has to be mine; the CT technologist must have finished the brain CT
I was expecting,’ says the radiologist, producing his pager from his lab
coat right pocket.
• “Are you Q4 or Q5?”
• “I am Q4.”
• “Where are you going on your next golden weekend, Peter?”
• “I’m go to Spain.”
• “What are the toughest days for a radiology resident, Sam?”
• “POSt-COH days are probably the toughest for a resident.”
• Radiologist: “Good morning Dr. Walker. I just reviewed your patient’s
MR, and wanted to discuss the findings with you ...”
• RadiolOgiSt: “Good morning Dr. Lee. I am reviewing Mrs. Carter’s abdominal US and would like to obtain more information on her presentation and past surgical history ...”
• Radiologist: “Dr Clark, thank you for contacting me regarding MrS.
McHugh’s CT. I received her prior studies from John Hopkin’s Hospital
and have been able to compare them with our most recent studies.
There has been no significant interval change in the appearance of the 4
cm liver lesion in segment VIII. I concur with the previous report: it
could be an FNH (focal nodular hyperplasia).”
• Radiologist: “If the lesion in the right temporal lobe is the area of concern, the next study of choice would be an enhanced brain MR.”
Radiology resident on call in ER (Emergency Room). Radiologist’s pager
goes oJ. Conversation with £fi physician in the emergency room (ER) at 3
• ER physician: “Hello, I would like to order a brain MR and CT of the abdomen and pelvis for Mrs. Smith (patient). She was recently diagnosed
with lung cancer and is being admitted for abdominal pain and further
oncologic workup.”
• RadiolOgist: “IS MYS. Smith having neurologic symptoms or is the brain
MR for staging?”
• ER physician: “For staging.”
• Radiologist: “If patient is having no neurologic symptoms and the brain
MR is requested for staging only, it is reasonable to obtain it as a ’next
available’ StHdy, since it is not emergent. The CT of the abdomen and
Unit XV On Call
pelvis is appropriate, given patient’s symptoms and will be done emergently. I will contact the CT technologist.”
Radiology resident finishing call, speaking to resident coming on call:
• Radiologist 1: “There are two studies pending. The first is a CT of the
abdomen and pelvis on a post op patient, Mr. Johnson, who is POD 10
from a gastrectomy, with persistent fevers and elevated white count. The
patient’s mediCal record number is 4444#. He is located in the ICU on
10D. The Contact person fOr the patient iS Dr. Jones (the surgery resident). His pager number is #####;. The second i5 patient iS Mrs. Simpson.
The technologist has already been contacted and has called for the patients. Transport is on the way.”
• Radiologist 2: “Thanks. I’ll follow up on these Studies and contact Dr.
Jones with the results.”
• Radiologist 2 (upon review of CT, radiologist has paged the referring
physician): “Dr. Jones, this is Dr. Miller, I am the radiologist On COll.
Thank you for calling back. I have reviewed Mr. Johnson’s CT and
wanted fo inform you of the findings. There is a mass in the liver ...”
Radiology resident on call, paged by clinical service:
• Radiologist: “This is Dr. Miller. I am the radiologist on call. I am returning a page. How can I help you!”
TechnologiSt: “Dr. Petit, you didn’t return a page from the cardiologist.”
Radiologist: “I haven’t been paged in the last couple of hours.”
Technologist: “Is your pager working properly?”
Radiologist: “I’m afraid it’s not working properly. Do you have some fresh
Doing an ultrasound examination at the ICU:
• Radiologist (speaking to ICU nurse): “Good afternoon, I am Dr. Miller.
I am here to do Mrs. Smith’s (patient) abdominal ultrasound. Is the patient under contact precautions!”
• Nurse: “Yes, patient is MRSA. The yellow contact gowns and gloves are
in the drawer by the entrance.”
• RadiolOgiSt: “Is the patient intubated? Can the patient be repositioned in
the left lateral decubitHS pOSltiOI1 ”
• Nurse: “Yes, patient is intubated but can be turned about 30 degrees.
I will get some extra help to move the patient.”
• Radiologist: “Thank you. I will Set up the ultrasound machine in the
• At about eight o’clock Fiona was signing out to Amy in the nurse’s station.
“There are just n couple of brain CTs pending; it’s been kind of quiet.”
• “The brain CT was not ordered because the patient was a DNR baby”
(DNR stands for “do not resuscitate”. DNR orders are written after care-
Additional Call Terms
ful consultation with all parties involved in the patient’s care, including
the child’s parents.)
“I was on call the night before last and I’m on again tonight. I’m doing
an every other night, which is fine, because i get the weekend off.’
“I am on on Monday and again on Wednesday so I’ll be post-Coll OH
Tuesday and ThHrSday but frOm then on it S "only” every third for the
rest of the month.”
“How was your call, Sam?”
“Not bad at all. I had a really easy night; i got only one hit.”
“I am scheduled to be on with really nice attendings during my next
three calls.”
• “For some reason I’ve woken up from my pre-call Sleep. I can’t help
thinking about my presentation on alveolar proteinosis.”
• “Call a code! When I entered the room everybody was starting to position the patient to start CPR.”
• “Attention, attention: CAC (clear all corridors) in the emergenC y room.”
• “Another brain CT? I can’t believe it. It seems like every walk-in (every
patient who comes to the emergency room) needs a brain CT.”
• “I just reviewed the X-rays and I see multiple fractures fhaf make me
suspect child abuse.”
• “The IV line has fallen out. I’m afraid we must replace it.”
• “No radiology resident came to the party. Everybody was either pre-call
or post-call.”
Additional Call Terms
• Pre-call/post-call: Day preceding or following call.
• “Q": Denotes frequency of call. For example, “I am Q4” means that call
is taken every 4 days.
• Golden weekend: Weekend uninterrupted by call. For example, on a Q4
call schedule, a golden weekend is flanked by a Thursday and Monday
• Home call: Call taken from home where issues resolvable by phone are
done so may require returning to the hospital for issues that require
personal presence.
• In-house Call: Person on call stays in the hospital for the duration of call.
• Night float: System of call where night coverage is assigned for several
days in a row (usually on a weekly basis). The person on call works at
night and is free of day-time responsibilities.
���� ���
Unit XVI Radiological Management
Diagnostic imaging represents a significant percentage of the average hospital’s revenue and often an even greater percentage of the organization’s
contribution margin. However, improving services has turned harder in an
environment of increasing competition.
Today’s radiology management includes several areas of responsibility. The
main areas are:
Operations improvement
Hospital relations
Business planning
New tool selection and implementation
Marketing planning
Profitability assurance
Quality control
Patient satisfaction
Safety surveillance
A radiology manager may be defined as a well-rounded, versatile, technically proficient, business-savvy, customer service-oriented professional with
multiple years of experience, professional certifications and higher degrees
employed to manage a radiology department ... seven days a week for a
minimum wage.
The radiology manager has responsibility for all the above areas listed
above and issues related to them. His/her focus and ultimate goal is to assure the continuous improvement of the radiology department. The radiology manager also dictates policies that aim to achieve these goals and create the necessary structure to implement and fulfil the mission of the department.
Unit XVI Radiological Management
Commonly Used Phrases
• We can’t hire another CT technologist, ... sorry, your extended schedule
has to wait (Hospital VP for ancillary).
• What do you mean by saying that your productivity is only 30% of
SCARD mean? (Hospital VP to Radiology Chair, when asked for subsidy).
• I believe we have tripled our volume since I arrived (any newly appointed Section Chief).
• One of my staff radiologists is leaving and we had an increase in interventional cases ... I need to hire two new faculty members (the same
Section Chief).
• We are working harder in our section than anywhere else, and don’t believe RVUs is a fair system to assess workload (any radiologist).
• With the reports you dictate it is impossible to bill! (coder).
• It takes at least 4 months to get new payer-approved radiologists; don’t let
them read until I tell you (billing office manager to the Chair).
Big Questions, Easy Answers
Q: We installed PACS four years ago; why are we still printing films? (Hospital COO)
A: PACS implementation does not eliminate the films in the OR, requested
by referring physicians, or patient copies.
Solution: Start distributing images in CD format.
Q: Does HIPAA regulations represent a risk for my business?
A: No. Even though HIPAA has been law since 1996 and therefore being
mandatory, and includes penalties for failure to comply, radiology managers concerns are limited to the enforcement of privacy and security
rules to protect patients’ sensitive personal information. Therefore,
every radiology practice must enforce and comply with HIPAA regulations, but they do not represent a risk if information is managed appropriately.
Q: How do some imaging centers manage to serve 150 patients per day
while maintaining a high level of patient satisfaction and others are
able to see only 75 patients with the same level infrastructure?
A: It is all about the revenue cycle. Improvement to details regarding scheduling and registration, patient communication, staffing resources,
documentation and the billing process, and reporting will ultimately
produce increased productivity and profitability.
Access: Time (days or hours) from test request to test completion. It is a
key measure when deciding expansion of services.
Balanced scorecard: The balanced scorecard is a management system that
enables organizations to clarify their vision and strategy and translate
them into action. It provides feedback around both the internal business
processes and external outcomes in order to continuously improve strategic performance and results.
Benchmarking: The process of setting goals, where these goals are chosen
by comparisons with other providers, drawn from the best practices
within the organization or industry. The benchmarking process identifies the best performance in the industry for a particular process or outcome, determines how that performance is achieved, and applies the lessons learned to improve performance.
Billings: Gross billed charges entered into the billing system for each CPT
Capitation: Method of payment for health services in which a physician or
hospital is paid a fixed amount for each person served regardless of the
actual number or nature of services provided.
Case-mix index (CMI): The average DRG weight for all cases paid under
PPS. The CMI is a measure of the relative costliness of the patients
treated in each hospital or group of hospitals (See alSO DRG).
Charge: The amount asked for a service by a health-care provider. Its contracted with the cost, which is the amount the provider incurs in furnishing the service.
Charge Lag: The number of days it takes to enter a service charge in the
billing system from the date of the service.
CFTE imputed: A measure of clinical activity of an individual physician or
group of physicians relative to the benchmark value for a given specialty.
This is computed by dividing the actual RVUs (work or total) generated
by the benchmark value selected in the report (mean, median, 75th percentile, etc).
CFTE reported: The percent of time spent in billable clinical activity, as reported by the participant. Participants must provide these data in order
to calculate other measures. Note: if you see patients where a bill is not
entered into the billing system from which data are submitted to the
FPSC, you should reduce the reported CFTE by the appropriate amount.
CFTE imputed/reported: The ratio of the imputed CFTE to the reported
CFTE. This ratio measures the relative productivity of providers. In
other words, it tells what an individual provider or group of providers is
producing compared to what is expected.
Clinical full-time equivalent (CFTE): The percent of full-time a provider
spends in billable, clinical activity. Percent clinical effort cannot exceed
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geneous with respect to resource use. Medicare’s PPS uses almost 500
mutually exclusive DRGs, each of which is assigned a relative weight that
compares its costliness to the average for all DRGs.
Effectiveness: The net health benefits provided by a medical service or
technology for typical patients in community practice settings.
Efficiency: Making the best use of available resources; i.e., getting good
value for resources.
Examination volume: Number of procedures performed by time unit, e.g.,
CT scans per year.
Fee-for-service: The traditional method for financing health services; pays
physicians and hospitals for each service they provide.
Fee schedule: A list of predetermined payment rates for medical services.
Fiscal year: A 12-month period for which an organization plans the use of
its funds. FYs are referred to by the calendar year in which they end; for
example, the Federal FY2006 began October 2005.
Full-time equivalent (FTE): A way to measure a worker’s productiv ity and/
or involvement in a project. An FTE of 1.0 means that the person is
equivalent to a full-time worker. An FTE of 0.5 may signal that the
worker is only half-time, or that his projected output is only half of
what one might expect.
Health maintenance organization (HMO): A managed care plan that integrates financing and delivery of a comprehensive set of health-care services to an enrolled population. HMOs may contract with, directly employ, or own participating health-care providers.
Health technology assessment: Evaluation of biomedical technology in relation to cost, efficacy, utilization, etc., and its future impact on social,
ethical, and legal systems.
HIPAA (Health Insurance Portability and Accountability Act): The Administrative Simplification provisions of the Health Insurance Portability
and Accountability Act of 1996 (HIPAA, title II) require the Department
of Health and Human Services (HHS) to establish national standards for
electronic health-care transactions and national identifiers for providers,
health plans, and employers. It also addresses the security and privacy
of health data. Adopting these standards will improve the efficiency and
effectiveness of the nation’s health-care system by encouraging the widespread use of electronic data interchange in health care.
Hospital costs: The expenses incurred by a hospital in providing care. The
hospital costs attributed to a particular patient care episode include the
direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc.
Hospital inpatient prospective payment system (PPS): Medicare’s method
of paying acute care hospitals for inpatient care. Prospective per case
payment rates are set at a level intended to cover operating costs for
treating a typical inpatient in a given DRG. Payments for each hospital
are adjusted for differences in area wages, teaching activity, care to the
poor, and other factors.
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Prospective payment: A method of paying health-care providers in which
rates are established in advance. Providers are paid these rates regardless
of the costs they actually incur.
Relative value unit (RVU): A non-monetary unit of measure used to express the time, complexity and cost of performing a given service relative to those of performing other procedures.
RVU/FTE ratio: A clinical productivity measure. It represents the average
output of each physician, and can be used as a workload measure.
Report turnaround: Time interval between the completion of a study and
the production of the final report.
Revenue: The inflow of assets that results from sales of goods and services
and earnings from dividends, interest, and rent.
In $/RVU: Represents the corresponding income for each worked unit.
SCARD (Society of Chairmen in Academic Radiology Departments): Nonprofit organization dedicated to the advancement of the art and science
of radiology by the promotion of medical education, research and patient care.
Spider graphs/charts: A technique or tool to combine analyses of a market’s level of managed care evolution with an internal readiness review.
It involves three steps: market assessment, internal analysis, and gap
analysis. Components of the graph include: network formation, managed
care penetration, utilization levels, reimbursement, excess inpatient capacity, geographic distribution, commercial premium, physician integration, managed care characteristics, employer and purchaser base, outcomes management, strategic alignment, organization and governance,
access to markets, delivery systems, medical management, finance, performance management, and information technology.
Standard: Something set up and established by authority as a rule for the
measure of quantity, weight, extent, value or quality.
Transcription time: Time measure from completion of a test to final report.
Technology adoption patterns: Organizational characteristic method of
providing new technologies; e.g., innovators are considered those hospi- tals
that develop their own technologies or that make them available to
the public at an early stage.
Total relative value unit (total RVU): The value consists of three components: the physician work involved (work RVU), practice overhead costs
(practice expense RVUs), and malpractice expense (malpractice RVUs).
RVUs are used as the basis for reimbursement of physicians’ services by
Medicare and by many other third-party players.
Utilization management (UM): The process of evaluating the necessity, appropriateness, and efficiency of health-care services against established
guidelines and criteria. Evaluation of the necessity, appropriateness, and
efficiency of the use of health-care services, procedures, and facilities.
Utilization review (UR): The review of services delivered to evaluate appropriateness, necessity, and quality. The review can be performed on a
prospective, concurrent, or retrospective basis.
Unit XVI Radiological Management
Work relative value unit (work RVU): A unit of measure used to expres5
the amount of effort (time, intensity of effort, technical skills) required
of a provider in performing a given service relative to other services.
1. Academy for Healthcare Management (2001) Managed healthcare: an introduction, 3rd edn. Academy for Healthcare Management, Washington DC
2. AcademyHealth (2004) Glossary of terms commonly used in health care. AcademyHealth, Washington DC
3. American Association of Health Plans (1996) Capitation: questions and answers. American Association of Health Plans, Washington DC
4. American Medical Association (1993) Advocacy brief: health reform glossary.
American Medical Association, Chicago, IL
5. Batstone G, Edwards M (1996) Achieving clinical effectiveness: just another
initiative or a real change in working practice? J Clin Effectiveness 1(1):19—21
6. Cofer J (1985) Legislative currents: Prospective Payment Assessment Commission (ProPAC). J Am Med Rec Assoc 56(3):28
7. Dorland’s Illustrated Medical Dictionary, 28th edn (1994). WB Saunders, Philadelphia
8. Drummond MF, O’Brien B, Stoddart GL, Torrance GW (1997) Methods for
the economic evaluation of health care programmes, 2nd edn. Oxford University Press, Oxford
9. Kelly MP, Bacon GT, Mitchell JA (1994) Glossary of managed care terms. J
Ambul Care Manage 17(1):70—76
10. Mar Queisser RL (1995) Carve-out bundled-service contracts: a new type of
CBC? Northwest Physician Magazine, Spring: 26—27
11. Medicare Payment Advisory Commission (1998) Medicare Payment Policy.
Report to the Congress. Medicare Payment Advisory Commission, Washington DC
12. National Library of Medicine (1994) HSTAR Fact Sheet. National Library of
Medicine, Bethesda, MD
13. National Library of Medicine. Medical Subject Headings. Available at: http://
14. National Library of Medicine. PubMed Tutorial Glossary. Available at: http://
15. New Jersey Hospital Association (2006) Glossary of healthcare terms and abbreviations. New Jersey Hospital Association, Princeton, NJ. Available at:
16. Office of Technology Assessment (1993) Benefit design: clinical preventive
services. Office of Technology Assessment, Washington, DC
17. Pam Pohly Associates (2006) Glossary of terms in managed health care. Pam
Pohly Associates, Hays, KS. Available at: http://www.poh1y.com
18. Physician Payment Review Commission (1996) Annual Report to the Congress. Physician Payment Review Commission, Washington DC
19. Pickett JP, et al (eds) (2000) The American heritage dictionary of the English
language, 4th edn. Houghton Mifflin Company, Boston, MA
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Unit XVII Radiological €onversation
With this guide we intend to provide radiologists with useful sentences, expressions, abbreviations, and acronyms frequently used in different radiological settings. You, as radiology resident, fellow or attending, must create
your own conversation guide with sentences frequently used at your institution. Medical and radiological jargon is so institution-specific that unless
you belong to a particular institution you will not understand some terms
and expressions used in that institution.
Medical language is complex and colorful. To address all radiological
terms and expressions is beyond the scope of this, and probably any, work.
Instead, this compilation focuses on terms and expressions not specifically
described in textbooks which have, over time, become part of the medical
language. Many of these terms are well known to a person who has trained
in an English-speaking environment but may not be familiar to others.
Some of the terms and expressions are encountered within radiology, while
others are more often used by non-radiologists but make their way into
our interactions with our colleagues and as part of medical histories. The
unit is divided into four sections:
Conversational abbreviations
Conversational acronyms
Made-up words/definitions/expressions
Conversational scenarios
Let there be no misunderstanding: those terms marked with a double asterisk, although used covertly, are not appropriate for use openly in any circumstances; other terms with no asterisk may not be appropriate in some
circumstances. If in doubt about a slang term, do not use it.
Conversational Abbreviations
Art line
Arterial line
Unit XVII Radiological Conversation Guide
Di-di pregnancy
Ex lap
Lap chole
Scope from above
Scope from below
Discontinue (or) discharge
Dichorionic-diamniotic twin gestation
Exploratory laparotomy
Laparoscopic cholecystectomy
Premature infant
To undergo endoscopy
Conversational Acronyms
(pronounced cabbage)
“a la casa” — to send the patient home
Coronary artery bypass graft
Coronary care unit
chest pain
Do not resuscitate
Deep venous thrombus
Endoscopic retrograde cholangiopancreatography
“Kidney ureters bladder” — abdominal radiograph
Gram-negative rod bacteria
Liver function tests
Myocardial infarction
Methicillin-resistant StaphylocoCcus aureus
No acute distress
Neurosurgical intensive care unit, or Neonatal intensive care unit, depending on context
Postoperative day (followed by number)
“Rule out myocardial infarction” — evaluation of a
patient suspected of suffering from a heart attack;
can be used as a verb
Surgical intensive care unit
(pronounced “sick-U 3’)
ST wave elevated myocardial infarction
Total abdominal hysterectomy/bilateral salpingoophorectomy
Urinalysis, or uric acid, depending on context
Usual state of health; for example: “Pt was in
USOH until 2 weeks ago when ...”
Made-Up Words/Definitions/Expressions
Ventricular fibrillation
“Weak and dizzy all over”
Made-Up Words/Definitions/Expressions
Chronically ill patient who will remain with a doctor until one of them expires
Ax or blade
or sturgeon**
Aunt Minnie lesion Once seen, never forgotten, much like certain aunts
at the family wedding. Processes with distinct and
unique imaging features that allow diagnosis without differential
Whole body radiograph of a newborn
Big C**
Boogie or goober**
Urine with blood in it
Patient who keeps returning to the hospital, a short
time after discharge
To die
To undergo bronchoscopy
To ready a patient for release
Buff up
Bug juice
Reference to the bottle of sparkling wine a junior
Champagne tap
resident should receive from his consultant after
achieving a bloodless lumbar puncture
Code brown
Fecal incontinence emergency
Code yellow
Urinary incontinence emergency
Nickname for dermatology department used by
staff in busier departments
Small urgent care medical facility, usually in a
shopping center, where one can go for treatment
without an appointment
Motorbike: frequent cause of organ donation
A doctor who is indiscriminate about prescribing
Dr. Feelgood**
drugs, particularly narcotics
Fake-oma or fakeout Imaging finding that mimics pathology or abnormality but is in fact normal
A “fascinating” tumor or pathological process, noFascinoma
table for it’s rarity or unusual presentation
Patient, usually of the ER, who frequently returns
Frequent flier
for care and is known by many employees of the
Unit XVII Radiological Conversation Guide
O sign**
Q sign**
Scut monkey**
Shotgun approach
St. Elsewhere**
Train wreck**
Vitamin H
Ordering all available tests because the person i5
unable to explain what is wrong with them or because symptoms are too vague to form a reasonable differential. Also see “shotgun approach”
Imaging or lab finding made while searching or
working-up a patient for an unrelated process
Comatose patient with mouth open wide
An O sign with the patient’s tongue hanging out —
a worse prognosis
Viewing a past case with the benefit of hindsight
A noun or a verb, referring to work that medical
students or lower-level residents have to do which
does not offer any learning opportunity, but needs
to get done
Person who performs more than his/her fair share
of scut
Ordering of a vast array of tests or imaging studies
in the hope that something will give an idea of
what is wrong with the patient
Medical academia’s term for any non-teaching hospital
Literally means above the falx tentorium/cerebellum, but is often used to imply a psychosomatic or
imagined process
A patient with many serious medical problems
To move a patient to a different service, as in “Turf
that woman in the ER to obstetrics”. Also, administrative/political conflict over division of certain
procedures by department
Intern or resident adept at not admitting patients
to his or her service
An unusually strange or unexpected disease (from
the saying “When you hear hoofbeats, the smart
money is on horses, not zebras”)
Conversational Scenarios
Radiologist preparing to perform an ultrasound on two-year-old Eric:
• Radiologist: “Good morning Mr. and Mrs. Brown (patient’s parents). I
am the radiologist, Dr. Miller. I’d like to talk to you about the examination I am about to perform on Eric (patient). Based on Eric’s symptoms
of projectile vomiting, it is believed that he may have a hypertrophic py-
Conversational Scenarios
loric stenosis. Thi5 iS a condition that can be established by ultrasound.
We can discuss the condition later in more detail but for now I would
like to focus on the ultrasound examination. The ultrasound examination is a non-invasive technique used to image structures by using
sound waves. Sometimes, pressure from the ultrasound probe may cause
discomfort, but the sound waves themselves cause no pain or damage to
the tissue. Do you have any questions? ...”
Patient, Mrs. Belmont, has questions regarding oral and intravenous contrast:
• Technologist: “Dr. Miller (radiologist), Mrs. Belmont (patient) is refusing
to drink the oral contrast because it tastes badly and she has questions
about potential complications from the intravenous contrast. She wishes
to speak to the radiologist.”
• Radiologist, speaking to patient: “Good morning Mrs. Belmont. I am the
radiologist, Dr. Miller. It’s a pleasure to meet you. Our technologist has
told me of your concern regarding both the oral and intravenous contrast. I would like to address your questions. Let me begin by saying that
the choice to accept or refuse oral and intravenous contrast is entirely
yours to make. However, I would like to convey to you the importance
of contrast. It is a tool that enables us to obtain more information from
the CT and makes the examination more useful. Allergic reactions can
be mild to severe, but in your case, you have no history of allergic reaction (had past contrast-enhanced CT without adverse reaction) and no
renal insufficiency so the risk of damage to your kidneys is minimal.
Some patients describe a warm sensation as the contrast is administered, but that is normal and expected. Ultimately, the choice is yours
but in this case, the benefits of using contrast are greater than the
Talking to referral physician:
• RadiolOgiSt: “GOOd morning Dr. Clark. I just reviewed your patient’s,
Mrs. Tall’s, CT and wanted to discuss the findings with you ...”
• Radiologist: “ Good morning Dr. Clark. I am reviewing Mrs. Tall’s abdominal CT and am hoping to obtain more information on her presentation and past surgical history ...”
• Radiologist: “Dr. Clark, Thank you for contacting me regarding Mrs.
Tall’s CT. I received the prior studies from Memorial Hospital and have
been able to compare them with our most recent studies. There has
been no significant interval change in the appearance of the 2 cm liver
lesion in segment VI. I suspect it may be a hemangioma. If that is the
area of concern, the next study of choice would be a multiphase CT or
MR with dynamic sequences ...”
Unit XVII Radiological Conversation Guide
Radiologist, 5peaking to mammography technologist:
• “Thelma (technologist), I just reviewed Mrs. Smith’s MLO and CC views.
There is an asymmetric density in the upper outer quadrant, seen on
the MLO view only. I’d like to get a spot compression in the ML projection.”
Talking to CT/MR technician:
• Radiologist: “Jim (technologist), can you reconstruct the upper abdomen
from the liver dome to the celiac trunk in 1 x 5's? I would like the images
reformatted in the sagittal and coronal plane as well.”
Talking to patient:
• Mr. Jones: “Doctor, will this hurt?”
• Dr. Smith: “We will use two different types of medication to make the
procedure as comfortable as possible. The first type of medication is
part of what is called intravenous conscious sedation. The medication
will be given to you through your IV line. One of the medications is for
pain and the other will make you a little sleepy. In addition to the medication through your IV, we will also be injecting a local anesthetic medication at the site of the procedure. That medication is similar to what
you receive at the dentist. It will make the skin numb. It may hurt
briefly at the very beginning but should not hurt once the medication
starts working which will take about one minute. As you will be awake,
you can let us know if you feel pain during the procedure and more
medication will be given to you.”
Radiologist preparing for procedure:
• Technologist: “Dr. Smith, Mr. Jones is on the table. Should I start
prepping?” (Prepping includes application of Betadine and placement of
sterile drapes.)
• Dr. Smith: “Yes, please start prepping. I’ll go scrub.” (Scrubbing is the
process of meticulously cleaning one’s hands with a scrub sponge.)
• Technologist: “I’ll have your gown ready for you. What size gloves do
you take?”
• Dr. Smifh: “I take 8s. Thanks.”
Talking to a patient about recovery and discharge:
• Dr. Smith: “Mr. Jones, everything went well during the procedure and
the results of the biopsy will be available in a few days. How are you
• Mr. Jones: “I am a little sleepy but fine otherwise.”
• Dr. Smith: “Good. As part of our standard protocol we would like to
keep you in recovery for 6 hours. Your wife is in the waiting area and
Conversational Scenarios
will be joining you shortly. Remember that you should not drive, operate
machinery or take part in any activity that is strenuous or requires
physical or mental effort for the rest of the day. The medication you
have received will keep you drowsy for a few hours. As part of your discharge packet, there is a list of signs and symptoms that you should be
aware of. I’ll go over the list with you. Here is my phone number. Do
not hesitate to contact me if you have any question5 or concerns.”
Obtaining informed consent:
• Dr. Smith: “Good morning Mr. Jones, I am Dr. Smith. I would like to
discuss the procedure planned for this morning. Let me begin by briefly
going over your past medical history and current concerns ... (Going
over a patient’s medical history establishes a rapport and link that radiologists often don’t have with patients. It places the procedure in the
proper context and shows that the interventional radiologist’s range extends beyond just doing a procedure.) ... Please feel free to correct any
information I have or to add any information you feel is relevant.
Let me then give you an overview of the procedure. You will not be
completely asleep for the procedure, so I will talk to you as we proceed
[Describe proCedure]. Do you have any questions thus far? (You can ask
the patient to re-explain the procedure to you in their own words to ensure that they understand. We often use technical terms without recognizing that most people are not familiar with those terms.)
As with any procedure, there are certain risks and alternatives [List or
describe risks ORd alternatives of the proCedure]. Some of the risks I described may seem worrisome but it’s important to keep them in the
proper context. We would not offer the procedure unless we thought that
the benefits of the procedure outweigh the risks.
Do you have any questions?”
Radiologist asking about an ICU patient undergoing an abdominal US
• Radiologist: “Is patient intubated? Can patient be repositioned in both
right and left lateral decubitus positions?”
• Nurse: “Yes, patient is intubated but can be turned about 30 degrees.
I will get some extra help to move the patient. Transport is on the way.”
���� �����
Unit XVIII Basic Communication Skills
in Medicine
In the following pages we show several key sentences which can help you
when interviewing a patient. In Table 1 we provide a list of common
phrases that patients use to describe their symptoms, and the meaning of
these phrases.
Greeting and Introducing Yourself
Good afternoon, Mr. Hudson. I’m Dr. Smith. How may I help you?
Good morning, Mr. Lee. Come and sit down. I’m Dr. Walker.
Good afternoon, Mrs. Belafonte. Take a seat, please.
Good afternoon, Mrs. Belafonte. I’m Dr. Smith. The technician told me
you wanted to talk to the radiologist.
Invitation to Describe Symptoms
Well now, what seems to be the problem?
What brought you in today?
Well, how can I help you?
Would you please tell me how I can help you?
Have you been having trouble with your blood pressure lately?
Where does your knee hurt?
Does lying down help the pain?
Does standing up make it worse?
What’s the pain like?
What kind of pain is it?
Can you describe your pain?
Does anything make it worse?
Is there anything else you feel at the same time?
Is there anything that makes it better?
How long does the pain last?
Have you taken anything for it?
Your GP (general practitioner) says you’ve been having trouble with
your right shoulder. Tell me about it.
Unit XVIII Basic Communication Skills in Medicine
Table 1. Common phrases used by patients, and their meaning
I can’t breath or I’m stuffed up or my chest is tight
Everything is spinning
It itches or I’m itching
It stings when I pee
I can’t eat or I’ve lost my appetite
I don’t feel like doing anything
My nose is dripping
I’ve vaginal dripping
I’m having my period
My hair is falling out
I can’t remember a thing
My skin looks yellow
I can’t move (a limb)
I can’t see anything
Bad breath
I’ve a cavity
It hurts when I swallow
I can’t swallow
I spit out phlegm (when I cough)
Cough up blood
My stomach is burning
I wheeze
I’ve a prickly sensation
I’ve a burning sensation
I feel like I’m going to throw up
I’m always running to the bathroom
I always feel like I have to pee
I’m always thirsty or I’m always dry
I’ve a rash
My ... is swollen
My skin looks blue
My chest feels constricted
Thoracic pain
My mouth is always watering
I can’t breathe when I lie down
My stool is black
My stool is white
My urine is dark
I can’t sleep
I can’t go to the bathroom
Instructions for Position on Couch
• My colleague, Dr. Sanders, says your left knee has been aching lately. Is
that correct?
• Have you had any pain in your ...?
• Have you ever coughed up blood?
• Have you had any shortness of breath?
• Any pain in your muscles?
• Have you lost any weight?
• Do you suffer from double vision?
Instructions for Undressing
Would you slip off your top things, please?
Slip off your coat, please?
Would you mind taking off all your clothes except your underwear? (men)
Please would you take off all your clothes except your underwear and
bra? (women)
You should take off your underwear too.
Lie on the couch and cover yourself with the blanket.
Lie on the stretcher with your shoes and socks off, please.
Roll your sleeve up, please, I’m going to examine your elbow.
Instructions for Position on Couch
• Make yourself comfortable on the couch and lie on your back (supine
• Lie down, please (supine position).
• Roll over onto your tummy (from supine to prone position).
• Lie on your tummy, please (prone position).
• Please turn over and lie on your back again.
• Bend your left knee.
• Straighten your leg again.
• Roll over onto your right 5ide.
• Keep the knee straight.
• Sit with your legs dangling over the edge of the couch.
• Lie down with your legs stretched out in front of you.
• Sit up and bend you knees.
• Lean forward.
• Get off the stretcher (“Get off” is sometimes perceived as too informal
and impolite).
• Please come off the couch.
• Please sit up.
• Get off the couch and stand up (“Get off” is sometimes perceived as too
informal and impolite).
Unit XVIII Basic Communication Skills in Medicine
Stand up from the couch.
Stand up, please.
Lie on your back with your knees bent and your legs wide apart.
Lie on your tummy and relax.
Let yourself go loose.
Instructions to Get Dressed
• You can get dressed now. Take your time, we are not in a hurry.
• Please get dressed. Take your time, we are not in a hurry.
No Treatment
• There is nothing wrong with you (It may be a quirk of the US healthcare system, but we are encouraged to validate a patient’s complaints.
Hence, even if nothing objective is identified, the patient’s symptoms are
still acknowledged. For example, I might say “I understand that you have
back pain. The MRI does not show any abnormality or anything that requires treatment. Our next step will be to ...”)
• This will clear up on its own.
• This illness is self-limited and will resolve on its own.
• There doesn’t seem to be anything wrong with your shoulder.
Questions and Commands
• To begin the interview:
— Well now, how can I help you?
— What’s brought you in today?
— What can I do for you?
— What seems to be the problem?
— Well, Mr. Goyen, what’s the trouble?
— Your doctor says you’ve been having trouble with your knees. Tell me
about it.
— How long has/have it/they been bothering you?
— How long have you had it/them?
— How long have you been ill?
— Did it start all of a sudden?
— How many days have you been indisposed?
— What do you think the reason is?
— Do you think there is any explanation?
Common Symptom Areas
• General questions/commands:
— How many times?
— How much?
— How often?
— How old are you?
— Have you had bleeding?
— Have you had fever?
— Have you had any nose bleeding?
— Have you lost weight lately?
— Open your mouth, please.
— Please remove your clothing.
— Raise your arm.
— Raise it more.
— Say it once again.
— Stick out your tongue.
— Swallow please.
— Take a deep breath.
— Breathe normally.
— Grasp my hand.
— Try again.
— Bear down as if for a bowel movement (Valsalva’s maneuver).
— Please lie on your tummy (prone position).
— Please turn over and lie on your back.
— Roll over onto your right/left side.
— Bend your knees.
— Keep your right knee bent.
— Lean forward.
— Walk across the room.
— You can get dressed now. There’s no hurry. Take your time.
Common Symptom Areas
• Questions:
— Which part of your (head, arm, face, chest, ...) is affected?
— Where does it hurt?
— Where is it sore?
— Can you describe the pain?
— What is the pain like?
— Is your pain severe?
— What kind of pain are you experiencing?
— Is there anything that makes it better?
— Does anything make it worse?
— Does anything relieve the pain?
Unit XVIII Basic Communication Skills in Medicine
— What effect doe5 food have?
— Does lying down help the pain?
• Describing the characteristics of pain:
— A dull sort of pain.
— A feeling of pressure.
— Very sore, like a knife.
— A burning pain.
— A gnawing kind of pain.
— A sharp, stabbing pain.
— Raw.
— The pain’s gone.
— A sharp pain.
— I ache all over.
— I’m in a lot of pain.
— I’ve got a very sore arm.
I think I have a temperature.
I think I’m running a fever.
High fever.
High temperature.
When do you have the highest temperature?
Do you shiver?
Do you have chills?
Were you cold last night?
When does your temperature come down?
I feel queasy.
I feel sick.
I think I’m going to vomit.
I think I’m going to throw everything up.
My head is (swimming) spinning.
I feel dizzy.
He’s feeling giddy.
She’s feeling faint.
• I feel weak.
• I’m tired.
Key Words About Symptoms and Signs
I’m not in the mood for ...
Are you hungry?
I’ve lost weight.
Do you still feel very weak?
Do you feel sleepy?
Do you sleep deeply?
I wake up too early.
Do you snore?
I can’t see properly.
Everything is fuzzy.
Everything is blurred.
I can’t see with my left/right eye.
My eye is itchy.
My eye is stinging/burning.
What have you done to your eye?
What’s happened to your eye?
Have you had a cough?
Do you pass any blood?
Do you have a discharge?
My foot has gone to sleep.
The patient went into a coma.
Key Words About Symptoms and Signs
General Symptoms
Anorexia (no appetite)
Vomiting (throw up)
Muscle pain
Unit XVIII Basic Communication Skills in Medicine
Weight loss
Weight gain
Night sweats
Regular movements
Respiratory System
Productive cough
Unproductive cough
Cough up blood
Cough up phlegm or spit
Runny nose
Sore throat
Pleuritic pain
Key Words About Symptoms and Signs
Out of puff
Chest pain
Breathless on lying down
Cardiovascular System
Chest pain
Pain behind the breast bone
Intermittent claudication
Gastrointestinal System
Abdominal pain
A coated tongue
Genitourinary System
Menstrual cramps
Unit XVIII Basic Communication Skills in Medicine
Nervous System
Jumbled speech
Knee jerk
Patient Examination
Initial Examination
• Level of consciousness:
— Altered level of consciousness
— GCS (Glasgow coma scale)
— Loss of consciousness
— Alert and oriented
• Circulation:
— Heart tones/sounds
— Clear
— Distant
— Regular/Irregular
— Muffled
— Pulse
• Breathing:
— Rhythm
— Depth
— Adequate
— Shallow
— Deep
— Quality
— Easy
— Labored
— Stridor
— Painful
— Shortness of breath
Patient Examination
Systematic Examination
• Respiratory system:
— Breathing
— Regular
— Easy
— Shallow
— Deep
— Non-productive cough
— Productive cough
— Chest auscultation
— Mucus and pink nail beds
— Telltale stains
• Cardiovascular system:
— No abnormalities in heart rate or rhythm
— Peripheral pulses
— Normal color and temperature of skin
— No ankle edema
• Gastrointestinal system:
— Abdomen soft, non-tender
— No nausea or vomiting
— No abnormalities in stool patterns or characteristics
— No change in dietary patterns
— Bowel sounds present
• Genitourinary system:
— No abnormalities in voiding patterns
— No abnormalities in color or characteristics of urine
— No vaginal or penile drainage
• Nervous system:
— Finger to finger
— Finger to nose
���� ���
Unit XIX Conversation Survival Guide
Fluency gives self-confidence and its lack undermines you.
The intention of this unit is not to replace conversation guides; on the
contrary, we encourage you, according to your level, to use them.
Without including translations, it would have been foolish to write a
conversation guide. Why, then, have we written this unit? The aim of the
unit is to provide a “survival guide”, a basic tool, to be reviewed by upperintermediate speakers who are actually perfectly able to understand all the
usual exchanges, but can have some difficulty in finding natural ways to
express themselves in certain unusual scenarios. For instance, we are strolling with a colleague who wants us to accompany him to a jeweler’s to buy
a bracelet for his wife. Bear in mind that, even in your own language, fluency is virtually impossible in all situations. I have only been upset and
disappointed (in English) three times. At a laundry, at an airport, and, on
a third occasion, at a restaurant. I considered myself relatively fluent in
English by that time but, under pressure, thoughts come to mind much
faster than words and your level of fluency can be overwhelmed as a consequence of the adrenaline levels in your blood. Accept this piece of advice:
unless you are bilingual you cannot afford to get into arguments in a language other than your own.
Many upper-intermediate speakers do not take a conversation guide
when traveling abroad. They think their level is well above those who need
a guide to construct basic sentences and are ashamed of being seen reading one (I myself went through this stage). I was (and they are) utterly
wrong in not taking a guide because, for upper-intermediate speakers, a
conversation guide has different and very important uses (as my level increased, I realized that my use of these guides changed; I did not need to
read the translations, except for a few words, and I just looked for natural
ways of saying things).
In my opinion, even for those who are bilingual, conversation guides are
extremely helpful whenever you are in an unfamiliar environment such as,
for example, a florist. How many names of flowers do you know in your
own language? Probably fewer than a dozen. Think that every conversation
scenario has its own jargon and a conversation guide can give you the
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Personal Data
Good morning.
Good afternoon.
Good evening.
Good night.
How are you? (Very) Well, thank you.
How are you getting on? All right, thank you.
I am glad to see you.
Nice to see you (again).
How do you feel today?
How is your family?
Good bye.
• Bye bye.
See you later.
See you soon.
See you tomorrow.
Give my regards to everybody.
Give my love to your children.
This is Mr./Mrs. ...
These are Mister and Missis ...
My name is ...
What is your name? My name is ...
Pleased/Nice to meet you.
Let me introduce you to ...
I’d like to introduce you to ...
Have you already met Mr. ...? Yes, I have.
Personal Data
What is your name? My name is ...
What is your surname/family name? My surname/family name is ...
Where are you from? I am from ...
Where do you live? I live in ...
What is your address? My address is ...
What is your email address? My email address is
Unit XIX Conversation Survival Guide
• What is your phone number? My phone number is ...
• What is your mobile phone/cellular number? My mobile phone/cellular
number is ...
• How old are you? I am ...
• Where were you born? I was born in ...
• What do you do? I am a radiologist.
• What do you do? I do MRI/US/CT/chest ...
Courtesy Sentences
Thank you very much. You are welcome (don’t mention it).
Would you please ...? Sure, it is a pleasure.
Excuse me.
Good luck!
It doesn’t matter!
May I help you?
Here you are?
You are very kind. It is very kind of you.
Don’t worry, that’s not what I wanted.
Sorry to bother/trouble you.
Don’t worry!
What can I do for you?
How can I help you?
Would you like something to drink?
Would you like a cigarette?
I would like ...
I beg your pardon.
Have a nice day.
Speaking in a Foreign Language
• Do you speak English/Spanish/French ... ? I do not speak English/Only a
bit/Not a word.
• Do you understand me? Yes, I do. No, I don’t.
• Sorry, I do not understand you.
• Could you speak slowly, please?
• How do you write it?
• Could you write it down?
At the Restaurant
How do you spell it?
How do you pronounce it?
Sorry, what did you say?
Sorry, my English is not very good.
Sorry, I didn’t get that.
Could you please repeat that?
I can’t hear you.
At the Restaurant
“The same for me” is one of the most common sentences heard at tables
around the world. The non-fluent English speaker links his/her gastronomic fate to a reportedly more fluent one in order to avoid uncomfortable
counter-questions such as “How would you like your meat, sir?”
A simple look at a guide a few minutes before the dinner will provide
you with enough vocabulary to ask for whatever you want.
Do not let your lack of fluency spoil a good opportunity to taste delicious dishes or wines.
Preliminary Exchanges
Hello, have you got a table for three people?
Hi, may I book a table for a party of seven at 6 o’clock?
What time are you coming, sir?
Where can we sit?
Is this chair free?
Is this table taken?
Waiter/waitress, I would like to order.
Could I see the menu?
Could you bring the menu?
Can I have the wine list?
Could you give us a table next to the window?
Could you give me a table on the mezzanine?
Could you give us a table near the stage?
We’d like to order now.
Could you bring us some bread, please?
We’d like to have something to drink.
Here you are.
Could you recommend a local wine?
Unit XIX Conversation Survival Guide
Could you recommend one of your specialties?
Could you suggest something special?
What are the ingredients of this dish?
I’ll have a steamed lobster, please.
How would you like your meat, sir?
Somewhere between rare and medium rare will be OK.
Is the halibut fresh?
What is there for dessert?
Anything else, sir?
No, we are fine, thank you.
The same for me.
Enjoy your meal, sir.
How was everything, sir?
The meal was excellent.
The sirloin was delicious.
Excuse me, I have spilt something on my tie. Could you help me?
The dish is cold. Would you please heat it up?
The meat is underdone. Would you cook it a little more, please?
Excuse me. This is not what I asked for.
Could you change this for me?
The fish is not fresh. I want to see the manager.
I asked for a sirloin.
The meal wasn’t very good.
The meat smells off.
Could you bring the complaints book?
This wine is off, I think ...
Waiter, this fork is dirty.
The Check (The Bill)
The check, please.
Would you bring us the check, please?
All together, please.
We are paying separately.
I am afraid there is a mistake, we didn’t have this.
This is for you.
Keep the change.
City Transportation
I want to go to the Metropolitan museum.
Which bus/tram/underground line must I take for the Metropolitan?
Which bus/tram/underground line can I take to get to the Metropolitan?
Where does the number ... bus stop?
Does this bus go to ...?
How much is a single ticket?
Three tickets, please.
Where must I get off for ...?
Is this seat occupied/vacant?
Where can I get a taxi?
How much is the fare for ...?
Take me to ... Street.
Do you know where the ... is?
Asking About Store Hours
• When are you open?
• How late are you open today?
• Are you open on Saturday?
Preliminary Exchanges
Hello sir (madam), may I help you?
Can I help you find something?
Thank you, I am just looking.
I just can’t make up my mind.
Can I help you with something?
If I can help you, just let me know.
Are you looking for something in particular?
I am looking for something for my wife.
I am looking for something for my husband.
I am looking for something for my children.
It is a gift.
Hi, do you sell ... ?
I am looking for a ... Can you help me?
Would you tell me where the music department is?
Which floor is the leather goods department on? On the ground floor
(on the mezzanine, on the second floor ...)
Unit XIX Conversation Survival Guide
Please would you show me ...?
What kind do you want?
Where can I find the mirror? There is a mirror over there.
The changing rooms are over there.
Only four items are allowed in the dressing room at a time.
Is there a public rest room here?
Have you decided?
Have you made up your mind?
Buying Clothes/Shoes
Please, can you show me some natural silk ties?
I want to buy a long-sleeved shirt.
I want the pair of high-heeled shoes I have seen in the window.
Would you please show me the pair in the window?
What material is it?
What material is it made of? Cotton, leather, linen, wool, velvet, silk,
nylon, acrylic fiber.
What size, please?
What size do you need?
Is this my size?
Do you think this is my size?
Where is the fitting room?
Does it fit you?
I think it fits well although the collar is a little tight.
No, it doesn’t fit me.
May I try a larger size?
I’ll try a 5maller size. Would you mind bringing it to me?
I’ll take this one.
How much is it?
This is too expensive.
Oh, this is a bargain!
I like it.
May I try this on?
In which color? Navy blue, please.
Do you have anything to go with this?
I need a belt/a pair of socks/pair of jeans/pair of gloves ...
I need a size 38.
I don’t know my size. Can you measure me?
Would you measure my waist, please?
Do you have a shirt to match this?
Do you have this in blue/in wool/in a larger size/in a smaller size?
Do you have something a bit less expensive?
I’d like to try this on. Where is the fitting room?
How would you like to pay for this? Cash/credit
We don’t have that in your 5ize/color.
We are out of that item.
It’s too tight/loose
It’s too expensive/cheap
I don’t like the color.
Is it in the sale?
Can I have this gift wrapped?
At the Shoe Shop
• A pair of shoes, boots, sandals, slippers ..., shoelace, sole, heel, leather,
suede, rubber, shoehorn.
• What kind of shoes do you want?
• I want a pair of rubber-soled shoes/high-heeled shoes/leather shoes/
suede slippers/boots.
• I want a pair of lace-up/slip-on shoes good for the rain/for walking.
• What is your size, please?
• They are a little tight/too large/too small.
• Would you please show me the pair in the window?
• Can I try a smaller/larger size, please?
• This one fits well.
• I would like some polish cream.
• I need some new laces
• I need a shoe-horn.
At the Post Office
I need some (first class) stamps, please.
First class, please.
Air mail, please.
I would like this to go express mail.
I would like this recorded/special delivery.
I need to send this second-day mail (US).
Second-class for this, please (UK).
I need to send this parcel post.
I need to send this by certified mail.
I need to send this by registered mail.
Return receipt requested, please.
How much postage do I need for this?
How much postage do I need to send this air mail?
Do you have any envelopes?
How long will it take to get there? It should arrive on Monday.
The forms are over there. Please fill out (UK fill in) a form and bring it
back to me.
Unit XIX Conversation Survival Guide
Going to the Theater (IIIA Theatre)
Sorry, we are sold out tonight.
Sorry, these tickets are non-refundable.
Sorry, there are no tickets available.
Would you like to make a reservation for another night?
I would like two seats for tonight’s performance, please.
Where are the best seats you have left?
Do you have anything in the first four rows?
Do you have matinees?
How much are the tickets?
Is it possible to exchange these for another night?
Do you take a check/credit cards?
How long does the show run? About two hours.
When does the show close?
Is there an intermission? There is an intermission.
Where are the rest rooms?
Where is the cloakroom?
Is there anywhere we can leave our coats?
Do you sell concessions?
How soon does the curtain go up?
Did you make a reservation?
What name did you reserve the tickets under?
The usher will give you your programme.
At the Drugstore (I//¢ Chemist)
• Prescription, tablet, pill, cream, suppository, laxative, sedative, injection,
bandage, sticking plasters, cotton wool, gauze, alcohol, thermometer, sanitary towels, napkins, toothpaste, toothbrush, paper tissues, duty chemist.
• Fever, cold, cough, headache, toothache, diarrhea, constipation, sickness,
insomnia, sunburn, insect bite.
• I am looking for something for ...
• Could you give me . . ?
• Could you give me something for ... ?
• I need some aspirin/antiseptic/eye drops/foot powder.
• I need razor blades and shaving foam.
• What are the side effects of this drug?
• Will this make me drowsy?
• Should I take this with meals?
At the Cosmetics Counter
• Soap, shampoo, deodorant, shower gel, hair spray, sun tan cream, comb,
hairbrush, toothpaste, toothbrush, make up, cologne water, lipstick, perfume, hair remover, scissors, face lotion, cleansing cream, razor, shaving
At the Bookshop/Newsagent’s
I would like to buy a book on the history of the city.
Has this book been translated into Japanese?
Have you got Swedish newspapers/magazines/books?
Where can I buy a road map?
At the Photography Shop
I want a 36 exposure film for this camera.
I want new batteries for my camera.
Could you develop this film?
Could you develop this film with two prints of each photograph?
How much does developing cost?
When will the photographs be ready?
My camera is not working, would you have a look at it?
Do you take passport (ID) photographs?
I want an enlargement of this one and two copies of this other.
Have you got a 64-megabyte data card to fit this camera?
How much would a 128-megabyte card be?
How many megapixels is this one?
Has it got an optical zoom?
Can you print the pictures on this CD?
At the Florist
I would like to order a bouquet of roses.
You can choose violets and orchids in several colors.
Which flowers are the freshest?
What are these flowers called?
Do you deliver?
Could you please send this bouquet to the NH Abascal hotel manager at
47 Abascal St. before noon?
• Could you please send this card too?
Unit XIX Conversation Survival Guide
Where is the cash machine?
Is there a cashpoint near here?
How much is that all together?
Will you pay cash or by credit card?
Next in line (queue).
Could you gift-wrap it for me?
Can I have a receipt, please?
Is there a cashpoint near here?
Can I have a receipt, please?
At the Hairdresser
When I was in Boston I went to a hairdresser’s and my lack of fluency was
responsible for a drastic change in my image for a couple of months so
that my wife almost did not recognize me when I picked her up at Logan
on one of her multiple visits to New England. I can assure you that I will
never forget the word “sideburns”; the hairdresser, a robust Afro-American
lady, drastically cut them before I could recall the name of this insignificant part of my facial hair. To tell you the truth, I did not know how important sideburns were until I didn’t have them.
If you do not trust an unknown hairdresser, “just a trim” would be a
polite way of avoiding a disaster.
I recommend, before going to the hairdresser, a thorough review of your
guide so that you get familiar with key words such as: scissors, comb,
brush, dryer, shampooing, hair style, hair cut, manicure, dyeing, shave,
beard, moustache, sideburns (!) (US), (sideboards (UK)), fringe, curl or
Men and IIIfomen
How long will I have to wait?
Is the water OK? It is fine/too hot/too cold.
My hair is greasy/dry.
I have dandruff.
I am losing a lot of hair.
A shampoo and rinse, please.
How would you like it?
Are you going for a particular look?
I want a (hair) cut like this.
Just a trim, please.
However you want.
Is it OK?
That’s fine, thank you.
How much is it?
How much do I owe you?
Do you do highlights?
I would like a tint, please.
I want a shave.
A razor cut, please.
Just a trim, please.
Leave the sideburns as they are (!) (UK sideboards).
Trim the moustache.
Trim my beard and moustache, please.
Towards the back, without any parting.
I part my hair on the left/in the middle.
Leave it long.
Could you take a little more off the top/the back/the sides?
How much do you want me to take off?
How do I set your hair?
What hair style do you want?
I would like my hair dyed.
Same color?
A little darker/lighter.
I would like to have a perm (permanent wave).
As always, begin with key words. Clutch, brake, blinkers (UK indicators),
trunk (UK boot), tank, gearbox, windshield (UK windscreen) wipers,
(steering) wheel, unleaded gas (UK petrol), etc, must belong to your fund
of knowledge of English, as well as several usual sentences such as:
• How far is the nearest gas (petrol) station? 20 miles from here.
• In what direction? Northeast/Los Angeles.
At the Gas/Petrol Station
Fill it up, please.
Unleaded, please.
Could you top up the battery, please?
Could you check the oil, please?
Unit XIX Conversation Survival Guide
Could you check the tyre pressures, please?
Do you want me to check the spare tyre too? Yes, please.
Pump number 5, please.
Can I have a receipt, please.
At the Garage
My car has broken down.
What do you think is wrong with it?
Can you mend a puncture?
Can you take the car in tow to downtown Boston?
I see ..., kill the engine, please.
Start the engine, please.
The car goes to the right and overheats.
Have you noticed if it loses water/gas/oil?
Yes, it’s losing oil.
Does it lose speed?
Yes, and it doesn’t start properly.
I can’t get it into reverse.
The engine makes funny noises.
Please, repair it as soon as possible.
I wonder if you can fix it temporarily.
How long will it take to repair?
I am afraid we have to send for spare parts.
The car is very heavy on petrol.
I think the right front tyre needs changing.
I guess the valve is broken.
Is my car ready?
Have you finished fixing the car?
Did you fix the car?
Do you think you can fix it today?
Could you mend a puncture?
I think I’ve got a puncture rear offside.
The spare’s flat as well.
I’ve run out of petrol.
At the Car Park
Do you know where the nearest car park is?
Are there any free spaces?
How much is it per hour?
Is the car park supervised?
How long can I leave the car here?
Having a Drink (or Two)
Renting a Car
I want to rent a car.
I want to hire a car.
For how many days?
Unlimited mileage?
What is the cost per mile?
Is insurance included?
You need to leave a deposit.
How Can I Get To ...?
How far is Minneapolis?
It is not far. About 12 miles from here.
Is the road good?
It is not bad, although a bit slow.
Is there a toll road between here and Berlin?
How long does it take to get to Key West?
I am lost. Could you tell me how I can get back to the toll road.
Having a Drink (or Two)
Nothing is more desirable than a drink after a hard day of meetings. In
such a relaxed situation embarrassing incidents can happen. Often, there is
a difficult counter-question to a simple “Can I have a beer?” such as
“would you prefer lager?” or “small, medium or large, sir?” From my own
experience, when I was a beginner, I hated counter-questions and I remember my face flushing when in a pub in London, instead of giving me the
beer I asked for, the barman responded with the entire list of beers in the
pub. “I have changed my mind, I’ll have a Coke instead” was my response
to both the “aggression” I suffered from the barman and the embarrassment resulting from my lack of fluency. “We don’t serve Coke here, sir.”
These situations can spoil the most promising evening so ... let’s review a
bunch of usual sentences:
Two beers please, my friend will pay.
Two pints of bitter and half a lager, please.
Where can I find a good place to go for a drink?
Where can we go for a drink at this time of the evening?
Do you know any pubs with live music?
What can I get you?
I’m driving. Just an orange juice, please.
A glass of wine and two beers, please.
Unit XIX Conversation Survival Guide
A gin and tonic.
A glass of brandy. Would you please warm the glass?
Scotch, please.
Do you want it plain, with water, or on the rocks?
Make it a double.
I’ll have the same again, please.
Two cubes of ice and a teaspoon, please.
This is on me.
What those ladies are having is on me.
On the Phone
Many problems start when you lift the receiver. You hear a continuous purring different from the one you are used to in your country or a strange sequence of rapid pips. Immediately “what the hell am I supposed to do right
now” comes to your mind, and we face one of the most embarrassing situations for non-fluent speakers. The phone has two added difficulties: firstly,
its immediacy and, secondly, the absence of image (“if I could see this guy
I would understand what he was saying”). Do not worry, the preliminary
exchanges in this conversational scenario are few. Answering machines are
another different, and tougher, problem and are out of the scope of this
survival guide. Just a tip: do not hang up. Try to catch what the machine is
saying and give it another try in case you are not able to follow its instructions. Many doctors, as soon as they hear the unmistakable sound of these
devices, terrified, hang up thinking they are too much for them. Most message5 are much easier to understand and less mechanical than those given
by “human” (and usually bored) operators.
Where are the public phones, please?
Where is the nearest call-box?
This telephone is out of order.
Operator, what do I dial for the USA?
Hold on a moment ... number one.
Would you get me this number please?
Dial straight through.
What time does the cheap rate begin?
Have you got any phone cards, please?
Can I use your cell/mobile phone, please?
Do you have a phone book (directory)?
I’d like to make a reverse charge call to Korea.
I am trying to use my phone card, but I am not getting through.
Hello, this is Dr. Vida speaking.
The line is engaged.
There’s no answer.
In the Bank
It’s a bad line.
I’ve been cut off.
I would like the number for Dr. Vida on Green Street.
What is the area code for Los Angeles?
I can’t get through to this number. Would you dial it for me?
Can you put me through to Spain?
Emergency Situations
• I want to report a fire/a robbery/an accident.
• This is an emergency. We need an ambulance/the police.
• Get me the police and hurry.
In the Bank
Nowadays, the spread of credit cards makes this section virtually unnecessary but, in my experience, when things go really wrong you may need to
go to a bank. Fluency disappears in stressful situations so, in case you have
to solve a bank problem, review not only this bunch of sentences but the
entire section in your guide.
Where can I change money?
I’d like to change 200 Euros.
I want to change 1000 Euros into Dollars/Pounds.
Could I have it in tens, please?
What’s the exchange rate?
What’s the rate of exchange from Euros to Dollars?
What are the banking hours?
I want to change this travelers’ check.
Have you received a transfer from Rosario Nadal addressed to Fiona
Can I cash this bearer check?
I want to cash this check.
Do I need my ID to cash this bearer check?
Go to the cash desk.
Go to counter number 5.
May I open a current account?
Where is the neare5t cash machine?
I am afraid you don’t seem to be able to solve my problem. Can I see
the manager?
Who is in charge?
Could you call my bank in France? There must have been a problem
with a transfer addressed to myself.
Unit XIX Conversation Survival Guide
At the Police Station
Where is the nearest police station?
I have come to report a ...
My wallet has been stolen.
Can I call my lawyer (UK solicitor)?
I have been assaulted.
My laptop has disappeared from my room.
I have lost my passport.
I will not say anything until I have spoken to my lawyer/solicitor.
I have had a car accident.
Why have you arrested me? I’ve done nothing.
Am I under caution?
I would like to call my embassy/consulate.